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Sample records for banded sleeve gastrectomy

  1. Laparoscopic Sleeve Gastrectomy versus Laparoscopic Banded Sleeve Gastrectomy: First Prospective Pilot Randomized Study

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    Valeria Tognoni

    2016-01-01

    Full Text Available Introduction. The placement of ring or band around the gastric tube might prevent the dilation after Laparoscopic Sleeve Gastrectomy (LSG. We describe the first randomized study comparing LSG and Laparoscopic Banded Sleeve Gastrectomy (LBSG. Material and Method. Fifty obese patients were enrolled in the study between January 2014 and January 2015. We analysed differences in operative time, complication rate, mortality, and BMI between the two groups over a period of 12 months. Results. Twenty-five patients received LSG (group A and 25 LBSG (group B. The mean preoperative BMI was 47.3±6.58 kg/m2 and 44.95±5.85 kg/m2, respectively, in the two groups. There was no statistical relevant difference in operative time. No intraoperative complications occurred. Mean BMI registered after 3, 6, and 12 months in groups A and B, respectively, were 37.86±5.72 kg/m2 and 37.58±6.21 kg/m2 (p=0.869, 33.64±6.08 kg/m2 and 32.03±5.24 kg/m2 (p=0.325, and 29.72±4.40 kg/m2 and 27.42±4.47 kg/m2 (p=0.186; no statistical relevant difference was registered between the two groups. Conclusion. LBSG is a safe and feasible procedure. The time required for the device positioning did not influence significantly the surgical time. The results of bodyweight loss did not document any statistically significant differences among the two groups, even though LBSG group showed a mean BMI slightly lower than that of the control group.

  2. Case for sleeve gastrectomy.

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    Corcelles, Ricard; Lacy, Antonio

    2016-07-01

    During the last 10 years, laparoscopic sleeve gastrectomy (LSG) has progressively increased in popularity as a primary procedure because of its simplicity, safety, and effectiveness to achieve sustained weight loss over time. The efficacy of LSG in the metabolic control of type 2 diabetes (T2D) is the result of various mechanisms not thoroughly elucidated. Thus, excellent short-term outcomes have been published in glycemic control after SG at comparable rates to Roux-en-Y gastric bypass (RYGB). Unfortunately, head-to-head comparative studies between SG and RYGB are limited and long-term follow-up data is not abundant. The aim of this manuscript is to describe current evidence on the clinical impact of SG on T2D as well as to provide a critical appraisal of the available published data. PMID:27568474

  3. Sleeve Gastrectomy and Gastroesophageal Reflux Disease

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    Michael Laffin

    2013-01-01

    Full Text Available Bariatric surgery, when combined with lifestyle and medical interventions, is a common and successful treatment modality in the obese patient. Laparoscopic sleeve gastrectomy is one such procedure that has increased in popularity as a definitive bariatric operation. Although laparoscopic sleeve gastrectomy has been shown to be effective in producing weight loss and improving type 2 diabetes mellitus, its effect on gastroesophageal reflux disease (GERD has been inconsistent. This paper aims to summarize the available literature regarding GERD prevalence following laparoscopic sleeve gastrectomy, 8 studies demonstrate increased GERD prevalence, and 5 demonstrate decreased GERD prevalence following laparoscopic sleeve gastrectomy. The relationship between GERD and SG is complex and no clear relationship exists. The anatomic and physiologic changes caused by laparoscopic sleeve gastrectomy are discussed in the context of these inconsistent results.

  4. The influence of laparoscopic adjustable gastric banding and laparoscopic sleeve gastrectomy on weight loss, plasma ghrelin, insulin, glucose and lipids

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    Hady Razak Hady

    2012-07-01

    Full Text Available The aim of this study was to assess the impact of laparoscopic gastric banding and laparoscopic sleeve gastrectomy on the concentration of ghrelin, insulin, glucose, triglycerides, total and HDL-cholesterol, as well as AST and ALT levels in plasma in patients with obesity. The research includes 200 patients operated using LAGB (34 men average age 37.0 ± 12.6 years and 66 women average age 39.18 ± 12.17 years and LSG (48 men average age 47.93 ± 9.24 years and 52 women, 19 ± 9.33 years. The percentage of effective weight loss, effective BMI loss, concentration of ghrelin, insulin, glucose, triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol, ALT, AST and HOMA IR values was taken preoperatively and at 7th day, 1 month, 3 and 6 months after surgery. Both after LSG and after LAGB, statistically significant reduction in BMI, serum insulin, glucose and HOMA IR was noticed in comparison to the preoperative values. Post LAGB, patients showed an increase of ghrelin, while LSG proved ghrelin decreased. Correlations between glucose and BMI loss, and between insulin and BMI loss in both cases are more favorable in the LSG group. Lipid parameters, AST and ALT have undergone declines or  increases in the particular time points. Both techniques cause weight loss and this way lead to changes in the concentration of ghrelin, as well as to the improvement of insulin, glucose, cholesterol and triglycerides metabolism. They reduce metabolic syndrome and multiple comorbidities of obesity.

  5. Gastroesophageal Reflux Disease and Sleeve Gastrectomy.

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    Melissas, John; Braghetto, Italo; Molina, Juan Carlos; Silecchia, Gianfranco; Iossa, Angelo; Iannelli, Antonio; Foletto, Mirto

    2015-12-01

    Gastroesophageal reflux disease (GERD) and/or hiatus hernia (HH) are one of the most common disorders of the upper gastrointestinal tract. Despite the positive effect of sleeve gastrectomy (SG) regarding weight loss and improvement in obesity co-morbidities, there are concerns about the development of de novo gastroesophageal reflux disease or worsening the existing GERD after this bariatric operation. Furthermore, controversy exists on the consequences of SG in lower esophageal sphincter function and about the ideal procedure when a hiatus hernia is preoperatively diagnosed or discovered during the laparoscopic SG. This review systematically investigates the incidence, the pathophysiology of GERD and/or HH in morbidly obese individuals before and after SG, and the treatment options for concomitant HH repair during laparoscopic sleeve gastrectomy. PMID:26428250

  6. An audit to determine if vitamin b12 supplementation is necessary after sleeve gastrectomy

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    Eltweri, Amar M.; Bowrey, David J.; Christopher D Sutton; Graham, Lisa; Williams, Robert N

    2013-01-01

    Abstract Sleeve gastrectomy has increased in popularity over the last five years and it is likely to supersede gastric banding. Nevertheless, it is unclear whether vitamin B12 supplementation is required after surgery. The aim of this short report is to identify any vitamin B12 deficiency and highlight the necessity of post laparoscopic sleeve gastrectomy vitamin B12 monitoring. Patients and methods A review of 66 patients underwent LSG in our institution. 25 patients were excluded as they ha...

  7. Simultaneous sleeve gastrectomy and hiatus hernia repair: a systematic review.

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    Mahawar, Kamal K; Carr, William R J; Jennings, Neil; Balupuri, Shlok; Small, Peter K

    2015-01-01

    Sleeve gastrectomy can exacerbate gastro-oesophageal reflux disease in some patients and cause de novo reflux in others. Some surgeons believe Roux-en-Y gastric bypass is the best bariatric surgical procedure for obese patients with hiatus hernia. Others believe that even patients with hiatus hernia can also be safely offered sleeve gastrectomy if combined with a simultaneous hiatus hernia repair. Still, others will offer these patients sleeve gastrectomy without any attempt to diagnose or repair hiatus hernia repair. The effectiveness of concurrent hiatal hernia repair in reducing the incidence of postoperative reflux after sleeve gastrectomy is unclear. This review systematically investigates the results and techniques of simultaneous sleeve gastrectomy and hiatus hernia repair for the treatment of obesity in accordance with PRISMA guidelines. PMID:25348434

  8. Laparoscopic sleeve gastrectomy for morbid obesity

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The incidence of obesity is steadily rising,and it has been estimated that 40% of the US population will be obese by the year 2025 if the current trend continues.In recent years there has been renewed interest in the surgical treatment of morbid obesity in concomitance with the epidemic of obesity.Bariatric surgery proved effective in providing weight loss of large magnitude,correction of comorbidities and excellent short-term and long-term outcomes,decreasing overall mortality and providing a marked survival advantage.The Laparoscopic Sleeve Gastrectomy (LSG) has increased in popularity and is currently very "trendy" among laparoscopic surgeons involved in bariatric surgery.As LSG proved to be effective in achieving considerable weight loss in the shortterm,it has been proposed by some as a sole bariatric procedure.This editorial focuses on the particular advantages of LSG in the treatment of morbid obesity.

  9. Safety Evaluation of Laparoscopic Sleeve Gastrectomy Compared with Two Procedures of Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Adjustable Gastric Banding for Individuals with Morbid Obesity: A Systemic Review

    Directory of Open Access Journals (Sweden)

    F Arabi Basharic

    2015-10-01

    Full Text Available Introduction: Laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding are the most common bariatric surgery procedures. Therefore, this study aims to compare the safety of the newer procedure of Laparoscopic sleeve gastrectomy compared to Laparoscopic Roux-en-Y gastric bypass and Laparoscopic adjustable gastric bonding. Method: A systematic review was conducted on the most important and most relevant search data bases, including Cochrane library, Pubmed, Ovid Medline as well as Iranian sites of Magiran , Iranmedex , SID, not taking the time limit into consideration. The results found in the literature were classified and were then analyzed. Results: Out of 384 articles obtained in the search, 4 randomized clinical trials (RCT were included in this study. There were no reports of death comparing surgical procedures of Roux-en-Y gastric bypass and sleeve gastrectomy. Moreover, in adjustable gastric banding and Roux-en-Y gastric bypass comparison, one death was observed in each group. Regarding the side effects of Roux-en-Y gastric bypass and sleeve gastrectomy, 10% early complications were reported in the Roux-en-Y gastric  bypass group , and 13% were observed in the sleeve gastrectomy group between which no statistically significant difference was revealed. The comparison between adjustable gastric banding and Roux-en-Y gastric bypass demonstrated that the occurrence of early and late complications was reported to be higher in the gastric bypass group, though no statistically significant difference was observed. Conclusion: The present study findings demonstrated no statistically significant difference between these methods in regard with the safety aspect. As a result, selection as well as success of the bariatric surgery procedures depend on the patient's and surgeon's preferences.

  10. Changes in problematic and disordered eating after gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy: a systematic review of pre-post studies.

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    Opozda, M; Chur-Hansen, A; Wittert, G

    2016-08-01

    Despite differences in their mechanisms and outcomes, little is known about whether postsurgical changes in eating behaviours also differ by bariatric procedure. Following a systematic search, 23 studies on changes in binge eating disorder (BED) and related behaviours, bulimia nervosa and related behaviours, night eating syndrome, grazing and emotional eating after Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) and vertical sleeve gastrectomy (VSG) were reviewed. Significant methodological problems and a dearth of literature regarding many behaviours and VSG were seen. Regarding BED and related behaviours, although later re-increases were noted, short to medium-term reductions after RYGB were common, and reported changes after AGB were inconsistent. Short to medium-term reductions in emotional eating, and from a few studies, short to long-term reductions in bulimic symptoms, were reported after RYGB. Reoccurrences and new occurrences of problem and disordered eating, especially BED and binge episodes, were apparent after RYGB and AGB. Further conclusions and comparisons could not be made because of limited or low-quality evidence. Long-term comparison studies of changes to problematic and disordered eating in RYGB, AGB and VSG patients are needed. It is currently unclear whether any bariatric procedure leads to long-term improvement of any problematic or disordered eating behaviours. PMID:27296934

  11. Roux-en-Y Gastric Bypass vs. Sleeve Gastrectomy vs. Gastric Banding: The First Multicenter Retrospective Comparative Cohort Study in Obese Korean Patients

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    Lee, Sang Kuon; Park, Joong-Min; Kim, Yong-Jin; Kim, Seong-Min; Park, Do-Joong; Han, Sang-Moon; Shim, Kyung Won; Lee, Yeon-Ji; Kwon, Jin-Won

    2016-01-01

    Purpose Bariatric surgery is relatively new in Korea, and studies comparing different bariatric procedures in Koreans are lacking. This study aimed to compare the clinical outcomes of laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) for treating morbidly obese Korean adults. Materials and Methods In this multicenter retrospective cohort study, we reviewed the medical records of 261 obese patients who underwent different bariatric procedures. Clinical outcomes were measured in terms of weight loss and resolution of comorbidities, such as diabetes, hypertension, and dyslipidemia. Safety profiles for the procedures were also evaluated. Results In terms of weight loss, the three procedures showed similar results at 18 months (weight loss in 52.1% for SG, 61.0% for LAGB, and 69.2% for RYGB). Remission of diabetes, hypertension, and dyslipidemia was more frequent in patients who underwent RYGB (65.9%, 63.6%, and 100% of patients, respectively). Safety profiles were similar among groups. Early complications occurred in 26 patients (9.9%) and late complications in 32 (12.3%). In the LAGB group, five bands (6.9%) were removed. Among all patients, one death (1/261=0.38%) occurred in the RYGB group due to aspiration pneumonia. Conclusion The three bariatric procedures were comparable in regards to weight-loss outcomes; nevertheless, RYGB showed a higher rate of comorbidity resolution. Bariatric surgery is effective and relatively safe; however, due to complications, some bands had to be removed in the LAGB group and a relatively high rate of reoperations was observed in the RYGB group. PMID:27189291

  12. Morbid obesity and sleeve gastrectomy: how does it work?

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    Papailiou, Joanna; Albanopoulos, Konstantinos; Toutouzas, Konstantinos G; Tsigris, Christos; Nikiteas, Nikolaos; Zografos, George

    2010-10-01

    Laparoscopic sleeve gastrectomy is known to be a safe and effective procedure for treating morbid obesity and is performed with increasing frequency both in Europe and the USA. Despite its broad use, many questions about the remaining gastric tube diameter, its long-term efficacy, its effects on gastric emptying, and the hormones involved still remain to be answered. In order to use such a relatively new surgical procedure wisely, it is essential for every surgeon and physician to understand how sleeve gastrectomy acts in obesity and what its potential benefits on the patients' metabolism are. This review focuses on the most important pathophysiologic questions referred to sleeve gastrectomy on the literature so far, in an attempt to evaluate the different issues still pending on the subject.

  13. Association between postprandial symptoms and gastric emptying after sleeve gastrectomy

    NARCIS (Netherlands)

    Burgerhart, J.S.; Rutte, P.W. van; Edelbroek, M.A.; Wyndaele, D.N.; Smulders, J.F.; Meeberg, P.C. van de; Siersema, P.D.; Smout, A.J.P.M.

    2015-01-01

    BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric procedure. However, postprandial symptoms can compromise its beneficial effect. It is not known if a changed gastric emptying and these symptoms are related. This study aimed to assess the association between postprandial sy

  14. Comparative effectiveness and safety of gastric bypass, sleeve gastrectomy and adjustable gastric banding in a population-based bariatric program: prospective cohort study

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    Gill, Richdeep S.; Majumdar, Sumit R.; Rueda-Clausen, Christian F.; Apte, Sameer; Birch, Daniel W.; Karmali, Shahzeer; Sharma, Arya M.; Klarenbach, Scott; Padwal, Raj S.

    2016-01-01

    Background Bariatric surgery in Canada is primarily delivered within publicly funded specialty clinics. Previous studies have demonstrated that bariatric surgery is superior to intensive medical management for reduction of weight and obesity-related comorbidities. Our objective was to compare the effectiveness and safety of laparoscopic Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (LSG) and adjustable gastric banding (LAGB) in a publicly funded, population-based bariatric treatment program. Methods We followed consecutive bariatric surgery patients for 2 years. The primary outcome was weight change (in kilograms). Between-group changes were analyzed using multivariable regression. Last-observation-carried-forward imputation was used for missing data. Results We included 150 consecutive patients (51 RYGB; 51 LSG; 48 LAGB) in our study. At baseline, mean age was 43.5 ± 9.5 years, 87.3% of patients were women, and preoperative body mass index (BMI) was 46.2 ± 7.4. Absolute and relative (% of baseline) weight loss at 2 years were 36.6 ± 19.5 kg (26.1 ± 12.2%) for RYGB, 21.4 ± 16.0 kg (16.4 ± 11.6%) for LSG and 7.0 ± 9.7 kg (5.8 ± 7.9%) for LAGB (p < 0.001). Change in BMI was greater for the RYGB (−13.0 ± 6.6) than both the LSG (−7.6 ± 5.7) and the LAGB (−2.6 ± 3.5) groups (p < 0.001). The reduction in diabetes, hypertension and dyslipidemia was greater after RYGB than after LAGB (all p < 0.05). There were no deaths. The anastomotic and staple leakage rate was 1.3%. Conclusion In a publicly funded, population-based bariatric surgery program, RYGB and LSG demonstrated greater weight loss than the LAGB procedure. Bypass resulted in the greatest reduction in obesity-related comorbidities. All procedures were safe. PMID:27240132

  15. Prosthetic Bioabsorbable Mesh for Hiatal Hernia Repair During Sleeve Gastrectomy

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    Clapp, Benjamin

    2013-01-01

    Background and Objectives: Laparoscopic sleeve gastrectomy has become a valuable primary bariatric operation. It has an acceptable complication profile and amount of weight loss. However, one of the most distressing complications to the patient is reflux postoperatively. There is thought to be a relationship between a hiatal hernia and postoperative reflux. There is disagreement on how to address a hiatal hernia intraoperatively, and the use of mesh is controversial. Our objectives were to ex...

  16. Lithium Toxicity Following Vertical Sleeve Gastrectomy: A Case Report.

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    Alam, Abdulkader; Raouf, Sherief; Recio, Fernando O

    2016-08-31

    We are presenting the first documented case of lithium toxicity after vertical sleeve gastrectomy surgery in an 18 year-old female with psychiatric history of bipolar disorder who was treated with lithium. This case illustrates the need for closer monitoring of lithium levels following bariatric surgery. Both psychiatrists and surgeons should be aware of the potential risk of lithium toxicity following bariatric surgery, as well as the need to judiciously monitor lithium level and possibly adjust the dose of some medications. PMID:27489390

  17. Wernicke’s encephalopathy after sleeve gastrectomy: Literature review

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    Pardo-Aranda, Fernando; Perez-Romero, Noelia; Osorio, Javier; Rodriguez-Santiago, Joaquín; Muñoz, Emilio; Puértolas, Noelia; Veloso, Enrique

    2016-01-01

    Objective To describe a case of Wernicke’s encephalopathy after laparoscopic sleeve gastrectomy. Setting Emergency Department and gastrointestinal surgery department. Case report A 20-year-old man class III obesity (BMI 50.17 kg/m2) underwent laparoscopic sleeve gastrectomy with uneventful recovery. Five weeks after surgery he was admitted in the Emergency Department because of persistent vomiting and dysphagia to solids. Esophagogastroduodenal transit and upper gastrointestinal endoscopy were requested but no relevant findings were shown. Laboratory analyses showed vitamin B1 12.2 ng/mL and 48 h following admission the patient experienced generalized weakness, sialorrhea and restrictions of actions such as reading a book. Neurological evaluation found confusion, motor ataxia, diplopy and nystagmus. A brain magnetic resonance was normal. According to low level of vitamin B1 and symptoms found in the patient a presumed diagnosis of Wernicke encephalopathy was made and parenteral thiamine 100 mg/day was started. The patient was discharged asymptomatic with oral intake of vitamin B1 600 mg per day. Conclusion Nutritional deficiencies after restrictive procedures are uncommon but easily preventable and can result in life threatening. With the upswing of bariatric surgery, surgeons and emergency physicians should be able to diagnose and treat those complications. Prophylactic thiamine should be administered to patients with predisposing factors. PMID:26826934

  18. A gastroplastia em manga (sleeve gastrectomy e o diabetes mellitus Sleeve gastrectomy and diabetes mellitus

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    Alexandre Ciro Andriani

    2008-09-01

    Full Text Available RACIONAL: O tipo 2 da diabete mellitus é muito frequente entre os pacientes de obesidade morbida. Ja foi provado cientificamente que o bypass gástrico pode curá-lo. Existem poucos relatos de que a gastroplastia em manga apresenta resultado promissores na cura desta forma de diabete. OBJETIVO: Apresentar resultados da glicemia em pacientes operados com a gastroplastia em manga mostrando sua possibilidade de controlar o dibetes. MÉTODO: Um estudo prospectivo envolvendo 15 pacientes foi realizado nos quais as dosagens sericas da glicose foram medidas no pré e pós-operatório. Para que houvesse homogeneidade da amostra, critérios de inclusão e exclusão foram estabelecidos com base nos pacientes com IMC de 35 a 40. Todos os pacientes foram submetidos a técnica cirurgica de gastroplastia em manga. O seguimento se deu em atendimento ambulatorial. RESULTADOS: Todos os pacientes foram operados pela técnica referida e seus níveis glicêmicos computados no pré, pós-operatório e no seguimento. CONCLUSÃO: A gastroplastia em manga cura o diabetes mellitus mostrando queda logo após a operação e mantendo-a ao longo do seguimento.BACKGROUND: The type 2 diabetes mellitus is very frequent among morbid obese patients. It has already been proven that the gastric bypass surgery may cures diabetes mellitus. There are few related studies to sleeve gastroplasty and diabetes. However, promising results exist. AIM: To analyse the glicemic results in patients submmitted to sleeve gastroplasty. METHODS: A 11 months prospective study on 15 patients was dome measuring their glycemic levels pre and postoperatively. The basic inclusion criteria was body mass index (BMI between 35 and 40 kg/m². All patients were operated by sleeve gastroplasty. RESULTS: All 15 patients lowered their glycemic level on their imidiate postoperative period and some achieved normal levels. CONCLUSIONS: The sleeve gastroplasty cures diabetes by lowering the plasma glucose and have

  19. Portal Vein Thrombosis due to Prothrombin Gene Mutation following Sleeve Gastrectomy

    OpenAIRE

    Murad Baba; Jordan Fakhoury; Amer Syed

    2015-01-01

    Introduction. Portomesenteric thrombosis is increasingly recognized as a complication of laparoscopic sleeve gastrectomy (LSG). It often presents with abdominal pain. We present a mother and her son who both developed portal vein thrombosis (PVT) after LSG. Case Description. A 43-year-old woman presented complaining of sudden severe abdominal pain, two weeks after she had uncomplicated laparoscopic sleeve gastrectomy. CT scan of the abdomen and pelvis with IV contrast showed portal vein throm...

  20. [Life-saving total gastrectomy in abdominal sepsis after bariatric surgery of gastric sleeve].

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    Barboza, E; Barboza, A; Calmet, F; Montes, M; Ronceros, V; Málaga, G; Gotuzzo, E; Sattui, A; Portugal, J; Mattos, L; Bocanegra, J; Vásquez, F; Contardo, M; Arias Stella, J

    2007-01-01

    Three obese patients underwent sleeve gastrectomy. They developed gastric dehiscence with generalized peritonitis, sepsis and shock, being operated as total gastrectomy of the remanent stomach with Roux in Y esophago-jejunostomy reconstruction as a last chance of life saving procedure. PMID:17934544

  1. Management of Super-super Obese Patients: Comparison Between Mini (One Anastomosis) Gastric Bypass and Sleeve Gastrectomy.

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    Madhok, Brijesh; Mahawar, Kamal K; Boyle, Maureen; Carr, William R J; Jennings, Neil; Schroeder, Norbert; Balupuri, Shlok; Small, Peter K

    2016-07-01

    Management of super-super obese patients poses a particular challenge for bariatric surgeons. Many staged algorithms exist for these patients. Essentially all of these involve a lower-risk procedure like sleeve gastrectomy first before a definitive second-stage procedure like gastric bypass or duodenal switch. This study compares our results with 19 mini (one anastomosis) gastric bypass and 56 sleeve gastrectomy in super-super obese patients. Sleeve gastrectomy patients were significantly older. There was no mortality or major complication in either group. There was no minor complication in mini (one anastomosis) gastric bypass group compared to two in the sleeve gastrectomy group. Mini (one anastomsosis) gastric bypass patients experienced significantly higher weight loss compared to sleeve gastrectomy patients at 6 months, 1 year, and 2 years after surgery.

  2. Preoperative endoscopy may reduce the need for revisional surgery for gastro-oesophageal reflux disease following laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Madhok, B M; Carr, W R J; McCormack, C; Boyle, M; Jennings, N; Schroeder, N; Balupuri, S; Small, P K

    2016-08-01

    Laparoscopic sleeve gastrectomy is a safe and effective bariatric operation, but postoperative reflux symptoms can sometimes necessitate revisional surgery. Roux-en-Y gastric bypass is the preferred operation in morbidly obese patients with gastro-oesophageal reflux disease. In 2011, we introduced preoperative endoscopy to assess for hiatus hernia or evidence of oesophagitis in conjunction with an assessment of gastro-oesophageal reflux symptoms for all patients undergoing bariatric surgery with a view to avoid sleeve gastrectomy for these patients. A prospectively maintained database was used to identify patients who underwent sleeve gastrectomy before and after we changed the unit policy. The need for revisional surgery in patients with troublesome gastro-oesophageal reflux disease was examined. Prior to 2011, 130 patients underwent sleeve gastrectomy, and 11 (8.5%) of them required conversion to Roux-en-Y gastric bypass for symptomatic reflux disease. Following the policy change, 284 patients underwent sleeve gastrectomy, and to date, only five (1.8%) have required revisional surgery (p = 0.001). Baseline demographics were comparable between the groups, and average follow-up period was 47 and 33 months, respectively, for each group. Preoperative endoscopy and a detailed clinical history regarding gastro-oesophageal reflux symptoms may improve patient selection for sleeve gastrectomy. Avoiding sleeve gastrectomy in patients with reflux disease and/or hiatus hernia may reduce the incidence of revisional surgery. PMID:27400631

  3. Clinical–radiologic evaluation of the complications of laparoscopic sleeve gastrectomy: Value of multidetector CT

    Directory of Open Access Journals (Sweden)

    Tamir A. Hassan

    2015-12-01

    Conclusions: As LSG is performed increasingly and frequently, it is essential for radiologists to recognize the normal postoperative anatomy and identify the complications of this procedure. CT is an important imaging tool to diagnose suspected complications of laparoscopic sleeve gastrectomy procedure to ensure accurate diagnosis.

  4. Gastric remnant twist in the immediate post-operative period following laparoscopic sleeve gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Gokulakkrishna; Subhas; Anupam; Gupta; Mubashir; Sabir; Vijay; K; Mittal

    2015-01-01

    Twist of stomach remnant post sleeve gastrectomy is a rare entity and difficult to diagnose pre-operatively. We are reporting a case of gastric volvulus post laparoscopic sleeve gastrectomy, which was managed conservatively. A 38-year-old lady with a body mass index of 54 underwent laparoscopic sleeve gastrectomy. Sleeve gastrectomy was performed over a 32 French bougie using Endo-GIA tri-stapler. On post-operative day 1, patient had nausea and non-bilious vomiting. An upper gastrointestinal gastrografin study on postoperative days 1 and 2 revealed collection of contrast in the fundic area of stomach with poor flow distally, and she vomited gastrograffin immediately post procedure. With the suspicion of a stricture in the mid stomach as the cause, the patient was taken back for a exploratory laparoscopy and intra-operative endoscopy. We found a twist in the gastric tube which was too tight for the endoscope to pass through. This was managed conservatively with a long stent to keep the gastric tube straight and patent. The stent was discontinued in 7 d and the patient did well. In laparoscopic sleeve gastrectomy the stomach is converted into a tube and is devoid of its supports. If the staples fired are not aligned appropriately, it can predispose this stomach tube to undergo torsion along its long axis. Such a twist can be avoided by properly aligning the staples and by placing tacking sutures to the omentum and new stomach tube. This twist is a functional obstruction rather than a stricture; thus, it can be managed by endoscopy and stent placement.

  5. Gastric remnant twist in the immediate post-operative period following laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Subhas, Gokulakkrishna; Gupta, Anupam; Sabir, Mubashir; Mittal, Vijay K

    2015-11-27

    Twist of stomach remnant post sleeve gastrectomy is a rare entity and difficult to diagnose pre-operatively. We are reporting a case of gastric volvulus post laparoscopic sleeve gastrectomy, which was managed conservatively. A 38-year-old lady with a body mass index of 54 underwent laparoscopic sleeve gastrectomy. Sleeve gastrectomy was performed over a 32 French bougie using Endo-GIA tri-stapler. On post-operative day 1, patient had nausea and non-bilious vomiting. An upper gastrointestinal gastrografin study on post-operative days 1 and 2 revealed collection of contrast in the fundic area of stomach with poor flow distally, and she vomited gastrograffin immediately post procedure. With the suspicion of a stricture in the mid stomach as the cause, the patient was taken back for a exploratory laparoscopy and intra-operative endoscopy. We found a twist in the gastric tube which was too tight for the endoscope to pass through. This was managed conservatively with a long stent to keep the gastric tube straight and patent. The stent was discontinued in 7 d and the patient did well. In laparoscopic sleeve gastrectomy the stomach is converted into a tube and is devoid of its supports. If the staples fired are not aligned appropriately, it can predispose this stomach tube to undergo torsion along its long axis. Such a twist can be avoided by properly aligning the staples and by placing tacking sutures to the omentum and new stomach tube. This twist is a functional obstruction rather than a stricture; thus, it can be managed by endoscopy and stent placement. PMID:26649158

  6. SLEEVE GASTRECTOMY IN PATIENTS WITH MORBID OBESITY AND HIV

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    PINTO, José Máximo Costa; de LIMA, Marianna Gomes Cavalcanti Leite; de ALMEIDA, Ana Luiza Melo Cavalcanti; SOUSA, Marcelo Gonçalves

    2016-01-01

    ABSTRACT Introduction: It is estimated that there are nearly 40 million people with the human immunodeficiency virus (HIV) worldwide. Due to the advent of antiretroviral drugs, it has been observed increasing in obesity and metabolic rates among patients undergoing treatment. Thus, numerous surgical therapies for weight loss are proposed for continuous improvement in health of patients with HIV, being the vertical gastrectomy an option for intact intestinal transit. Objective: To evaluate the applicability of the vertical gastrectomy in patients with morbid obesity and HIV. Methods: Was conducted a systematic review of the literature, in the electronic databases Scopus, Pubmed, Cinahl, Scielo, Cochrane and Lilacs, from 1998 to 2015. MeSH headings used in data collection were "Gastrectomy" and "Morbid obesity" being combined with the descriptor "HIV". Were found 2148 articles in Scopus, 1234 in PubMed and 784 in Cinahl. The articles were analyzed by the Jadad Quality Scale, being reduced to 40 articles, subsequently reassessed using an elaborated form by the Critical Appraisal Skills Programme (CASP), reaching 12 articles in the end. Conclusion: It was found that vertical gastrectomy constitutes a safe and effective method, with low mortality and low rate of postoperative complications, being recommended as surgical technique in patients with obesity, HIV and comorbidities. PMID:27683793

  7. Simple, Safe, and Cost-Effective Technique for Resected Stomach Extraction in Laparoscopic Sleeve Gastrectomy

    Directory of Open Access Journals (Sweden)

    Serhan Derici

    2016-01-01

    Full Text Available Background. Laparoscopic sleeve gastrectomy (LSG has become a popular operation during the recent years. This procedure requires resection of 80–90% of the stomach. Extraction of gastric specimen is known to be a challenging and costly stage of the operation. In this paper, we report results of a simple and cost-effective specimen extraction technique which was applied to 137 consecutive LSG patients. Methods. Between October 2013 and October 2015, 137 laparoscopic sleeve gastrectomy surgeries were performed at Dokuz Eylul University General Surgery Department, Upper Gastrointestinal Surgery Unit. All specimens were extracted through a 15 mm trocar site without using any special device. Results. We noticed one superficial incisional surgical site infection and treated this patient with oral antibiotics. No cases of trocar site hernia were observed. Conclusion. Different techniques have been described for specimen extraction. This simple technique allows extraction of specimen safely in a short time and does not require any special device.

  8. Portal Vein Thrombosis due to Prothrombin Gene Mutation following Sleeve Gastrectomy

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    Murad Baba

    2015-01-01

    Full Text Available Introduction. Portomesenteric thrombosis is increasingly recognized as a complication of laparoscopic sleeve gastrectomy (LSG. It often presents with abdominal pain. We present a mother and her son who both developed portal vein thrombosis (PVT after LSG. Case Description. A 43-year-old woman presented complaining of sudden severe abdominal pain, two weeks after she had uncomplicated laparoscopic sleeve gastrectomy. CT scan of the abdomen and pelvis with IV contrast showed portal vein thrombosis and SMV thrombosis. Two weeks later her son had the same LSG for morbid obesity and presented with the same clinical picture. Thrombophilia workup showed heterozygous prothrombin gene mutation. Conclusions. A high index of suspicion is necessary to diagnose PVT; although rare, it can be potentially lethal. Anticoagulation therapy should be initiated immediately to limit the morbidities and improve the outcome. Patients with family history of thrombophilia should be investigated prior to any bariatric surgery and nonsurgical alternative treatments for morbid obesity should be strongly encouraged.

  9. Sleeve gastrectomy prevents lipoprotein receptor-1 expression in aortas of obese rats

    Institute of Scientific and Technical Information of China (English)

    Jie Bai; Yong Wang; Yuan Liu; Dong-Hua Geng; Jin-Gang Liu

    2011-01-01

    AIM: To investigate the effects of sleeve gastrectomy on adipose tissue infiltration and lectin-like oxidized low density lipoprotein receptor-1 (LOX-1) expression in rat aortas.METHODS: Twenty-four rats were randomized into three groups: normal chow (control), high fat diet (HD) and high fat diet with sleeve gastrectomy (SG). After surgery, the HD and SG groups were fed a high fat diet. Animals were sacrificed and plasma high density lipoprotein (HDL) and low density lipoprotein (LDL) lev-els were determined. LOX-1 protein and LOX-1 mRNA expression was also measured. Aortas were stained with Nile red to visualize adipose tissue.RESULT: Body weights were higher in the HD group compared to the other groups. HDL levels in control, HD, and SG groups were 32.9 ± 6.2 mg/dL, 43.4 ± 4.0 mg/dL and 37.5 ± 4.3 mg/dL, respectively. LDL levels in control, HD, and SG groups were 31.8 ± 4.5 mg/dL, 53.3 ± 5.1 mg/dL and 40.5 ± 3.7 mg/dL, respectively. LOX-1 protein and LOX-1 mRNA expression was greater in the HD group versus the other groups. Staining for adipose tissue in aortas was greater in the HD group in comparison to the other groups. Thus, a high fat diet elevates LOX-1 protein and mRNA expression in aorta. CONCLUSION: Sleeve gastrectomy decreases plasma LDL levels, and downregulates LOX-1 protein and mRNA expression.

  10. A prospective study on inflammatory parameters in obese patients after sleeve gastrectomy.

    Science.gov (United States)

    Gumbau, Verónica; Bruna, Marcos; Canelles, Enrique; Guaita, Marcos; Mulas, Claudia; Basés, Carla; Celma, Isabel; Puche, Jose; Marcaida, Goitzane; Oviedo, Miguel; Vázquez, Antonio

    2014-06-01

    Different hormones and peptides involved in inflammation have been studied in and related to obesity. The aim of our work is to assess the variations of different molecules related to inflammation in obese patients during the first year following sleeve gastrectomy. This was a prospective study on patients who underwent sleeve gastrectomy. The variations in different clinical, anthropometric, and analytical parameters related to inflammation were determined and analysed in all patients at the preoperative visit and at the first and fifth days, first and sixth months, and 1 year following surgery. We enrolled 20 patients to the study. The median body mass index (BMI) before intervention was 48.5 kg/m2. With respect to comorbidities, 70% of the patients had obstructive sleep apnoea syndrome (OSA), 65% high blood pressure, 45% dyslipidaemia, and 40% diabetes mellitus (DM). The median percentage of BMI lost (%BMIL) 1 year after the intervention was 71%. The dyslipidaemia healing or improvement rate was 100%, whereas it was 87.5% for diabetes, 84.6% for hypertension, and 57.1% for OSA. During the 1-year postintervention period, the average levels of adiponectin increased, although not significantly, whereas those of leptin significantly decreased. In addition, the blood levels of MCP-1, IL-6, CRP, ferritin, and PAI-1 significantly decreased in that period. Sleeve gastrectomy is a surgical technique that is associated with improvements in body weight and comorbid conditions from the first postoperative months, which lead to significant variations in the levels of different inflammation-related parameters and a decrease in the levels of leptin, IL-6, CRP, MCP-1, ferritin, and serpin (PAI-1). PMID:24566661

  11. Potential Mechanisms Mediating Sustained Weight Loss Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy.

    Science.gov (United States)

    Makaronidis, Janine M; Batterham, Rachel L

    2016-09-01

    Bariatric surgery is the only effective treatment for severe obesity. Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), the most commonly performed procedures, lead to sustained weight loss, improvements in obesity-related comorbidities and reduced mortality. In humans, the main driver for weight loss following RYGB and SG is reduced energy intake. Reduced appetite, changes in subjective taste and food preference, and altered neural response to food cues are thought to drive altered eating behavior. The biological mediators underlying these changes remain incompletely understood but changes in gut-derived signals, as a consequence of altered nutrient and/or biliary flow, are key candidates.

  12. Novel oesophago-gastro-duodenal stenting for gastric leaks after laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Liu, Shirley Yuk-Wah; Wong, Simon Kin-Hung; Ng, Enders Kwok-Wai

    2015-01-01

    The management of gastric leak after laparoscopic sleeve gastrectomy (LSG) can be complex and challenging. Whilst operative interventions are mostly complicated and reserved for unstable or refractory cases, endoscopic self-expandable metal stenting (SEMS) is increasingly preferred as a safer treatment option. Yet, SEMS carries the problems of frequent stent migration and inconsistent healing as ordinary SEMS is designed mainly for stenotic disease. We hereby present two cases of early and chronic post-LSG leakage that were respectively failed to be treated by surgery and ordinary SEMS but were successfully managed by a dedicated extra-long oesophago-gastro-duodenal stent. In oesophago-gastro-duodenal stenting, the characteristics of extra-long stent length allow total gastric exclusion between the mid-oesophagus and the first part of duodenum to prevent stent migration and to equalise high pressure gradient within the gastric sleeve to promote fistula healing.

  13. Effects of duodenal switch alone or in combination with sleeve gastrectomy on body weight and lipid metabolism in rats

    OpenAIRE

    Gudbrandsen, Oddrun Anita; Kodama, Yosuke; Mjøs, Svein Are; Zhao, Chun-Mei; Johannesen, Helene; Brattbakk, Hans-Richard; Haugen, Christine; Kulseng, Bård Eirik; Mellgren, Gunnar; Chen, Duan

    2014-01-01

    Background: A combined procedure of sleeve gastrectomy and duodenal switch (SG+DS) has been applied to the treatment of super obesity. The aim of the present study was to test whether duodenal switch alone (DS) leads to similar weight loss and changes in lipid metabolism as SG+DS. Methods: Male Sprague–Dawley rats underwent sham surgery (Sham, N=7), duodenal switch alone (DS, N=5) or sleeve gastrectomy followed by duodenal switch (SG+DS, N=5). Body weight, feed and water intakes, and ambul...

  14. Laparoscopic Sleeve Gastrectomy as a Primary Operation for Morbid Obesity: Experience with 200 Patients

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    Paolo Gentileschi

    2012-01-01

    Full Text Available Introduction. Laparoscopic sleeve gastrectomy (LSG represents a valid option for morbid obesity, either as a primary or as a staged procedure. The aim of this paper is to report the experience of a single surgeon with LSG as a standalone operation for morbid obesity. Methods. From April 2006 to April 2011, 200 patients underwent LSG for morbid obesity. Each patient record was registered and prospectively collected. In July 2011, a retrospective analysis was conducted. Results. Patients were 128 females and 72 males with a median age of 40.0 years. Median pre-operative BMI was 49.4 kg/m2. Median follow-up was 27.2 months. Median post-operative BMI was 30.4 kg/m2. Median %excess weight loss (%EWL was 63.6%. Median post-operative hospital stay was 4.0 days in the first 84 cases and 3.0 days in the last 116 cases. Six major post-operative complications occurred (3%: two gastric stump leaks (1%, three major bleedings (1.5% and 1 (0.5% bowel obstruction. One case of mortality was registered (0.5%. To date only 4 patients are still in the range of morbid obesity (BMI > 35 kg/m2. Conclusions. Laparoscopic sleeve gastrectomy is a formidable operation in the short-term period. Median %EWL in this series was 63.6% at 27.2 months follow-up.

  15. A Sleeve Gastrectomy Complicated by Mesenteric Vein Thrombosis, Abdominal Compartment Syndrome and Pulmonary Emboli: Case Report

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    Erika Leung

    2015-09-01

    Full Text Available Background: Obesity is a growing problem all over the world, including the United States. Single-incision laparoscopic sleeve gastrectomy is a surgery performed for patients who want to lose weight. The number of deaths resulting from thromboembolic complications from bariatric surgeries continues to be of major concern. Case Description: A 38-year-old female was admitted for single incision sleeve gastrectomy and was discharged home three days later. Subsequently she began to have abdominal pain, nausea and vomiting. A CT scan revealed superior mesenteric vein thrombosis with small bowel ischemia, splenic infarction and main and right portal vein branch thrombosis. An exploratory laparotomy demonstrated necrotic bowel due to abdominal compartment syndrome, and an area of small bowel was resected due to internal hernia. Surgical management of the patient during her second hospital stay included a decompressive laparotomy, internal hernia reduction, a small bowel resection. Discussion: Superior mesenteric vein thrombosis can be a life-threatening complication and present with non-specific presentations; thus, it is imperative that it is identified and managed promptly as these cases carry significant morbidity and mortality. Obese patients who undergo bariatric surgery frequently have other co-morbidities; many of which can complicate a case further. Mesenteric vein thromboses are normally treated with unfractionated or low-molecular-weight heparin.

  16. Secondary surgery after sleeve gastrectomy: Roux-en-Y gastric bypass or biliopancreatic diversion with duodenal switch

    NARCIS (Netherlands)

    Homan, J.; Betzel, B; Aarts, E.O.; Laarhoven, K.J. van; Janssen, I.M.C.; Berends, F.J.

    2015-01-01

    BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has gained popularity as a stand-alone procedure with good short-term results for weight loss. However, in the long-term, weight regain and other complications are reported. Demand for secondary surgery is rising, partly for these reasons. OBJECTIVES

  17. The hidden endoscopic burden of sleeve gastrectomy and its comparison with Roux-en-Y gastric bypass

    Science.gov (United States)

    Arndtz, Katherine; Steed, Helen; Hodson, James; Manjunath, Srikantaiah

    2016-01-01

    Background This study aimed to assess the endoscopic burden of bariatric surgical procedures at our trust. This is an enhanced parallel study to “The Hidden Endoscopic burden of Roux-en-Y Gastric Bypass” published in Frontline Gastroenterology in 2013 incorporating the data for sleeve gastrectomy and comparison with Roux-en-Y gastric bypass (RYGB). Methods This is a retrospective study that included 211 patients undergoing sleeve gastrectomy over a 34-month period. We utilized previously collected data for the RYGB patient cohort which included 553 patients over a 29-month period. We searched our hospital endoscopic database for patients who underwent post-operative endoscopy for indications related to their surgery. Results 16.6% of the sleeve gastrectomy patients required post-operative endoscopy, of whom 11.4% underwent therapeutic procedures. This compares to 20.4% of the RYGB cohort of whom 50.4% needed therapeutic procedures (P<0.001). 1.9% of sleeve gastrectomy patients encountered a post-operative staple line leak and collectively required 29 endoscopic procedures. One patient also developed stricturing (0.47%) requiring 18 pneumatic dilatations. 11.4% of the RYGB cohort developed an anastomotic stricture requiring 57 balloon dilatation procedures. To date, these procedures have accumulated an equivalent cost of €159,898 in endoscopy tariffs, or €177 per RYGB and €373 per sleeve gastrectomy performed. Conclusions Bariatric surgery can have significant implications in terms of patient morbidity and financial cost. Having a local bariatric surgery service increases the demand for endoscopic procedures in our hospital, both in investigating for and dealing with post-operative complications. Provision of extra resources and expertise needs to be taken into account. PMID:26752949

  18. Portomesenteric venous thrombosis after laparoscopic sleeve gastrectomy: A case report and a call for prevention

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    Parveen Bhatia

    2015-01-01

    Full Text Available Postoperative portomesenteric venous thrombosis (PMVT is being increasingly reported after bariatric surgery. It is variable and often a nonspecific presentation along with its potential for life-threatening and life-altering outcomes makes it imperative that it is prevented, detected early and treated optimally. We report the case of a 50-year-old morbidly obese man undergoing a laparoscopic sleeve gastrectomy who developed symptomatic PMVT two weeks postsurgery, which was successfully treated by anticoagulant therapy. We provide postulates to the etiopathological mechanism for this thrombotic entity. The growing recognition that obesity and bariatric surgery create a procoagulant state regionally and systemically provides impetus for designing the ideal protocol for PMVT prophylaxis, which could be more common than currently believed. We support the early screening for PMVT in the postbariatric surgical patient with unexplainable or intractable abdominal symptoms. The role of routine surveillance and the ideal duration of post-PMVT anticoagulation is yet to be elucidated.

  19. The Use of Serum Uric Acid Concentration as an Indicator of Laparoscopic Sleeve Gastrectomy Success

    Science.gov (United States)

    Menenakos, Evangelos; Doulami, Georgia; Tzanetakou, Irene P.; Natoudi, Maria; Kokoroskos, Nikolaos; Almpanopoulos, Konstantinos; Leandros, Emmanouil; Zografos, George; Theodorou, Dimitrios

    2015-01-01

    Laparoscopic sleeve gastrectomy (LSG) effectively reduces weight by restricting gastric capacity and altering gut hormones levels. We designed a prospective study to investigate the correlation of serum uric acid (SUA) concentration and weight loss. SUA and body mass index (BMI) were measured preoperatively and on first postoperative month and year in patients who underwent LSG in our department of bariatric surgery. Data on 55 patients were analyzed. Preoperative SUA concentration had a significant positive correlation with percentage of total weight loss (TWL) on first postoperative month (P = 0.001) and year (P = 0.002). SUA concentration on first postoperative month had a positive correlation with percentage of TWL on first postoperative year (P = 0.004). SUA concentration could be used as a predictor of LSG's success and could help in early detection of patients with rapid loss of weight, in order to prevent complications. PMID:25594659

  20. The success of sleeve gastrectomy in the management of metabolic syndrome and obesity

    Institute of Scientific and Technical Information of China (English)

    Asim Shabbir; Dallan Dargan

    2015-01-01

    The rapid reversal of diabetes,hypertension,hyperlipidaemia and obesity by surgical means has challenged accepted doctrines regarding the management of metabolic syndrome.Sleeve gastrectomy,which developed initially as a preparatory procedure for biliopancreatic diversion with duodenal switch,has seen an exponential rise in popularity as an effective lone laparoscopic bariatric procedure.Superior excess weight loss,a low complication rate,and excellent food tolerance,combined with a short hospital stay,have made this the procedure of choice for patients and surgeons across the globe.High volume centres nurture the ongoing development of experienced and specialized teams,pathways and regimens.Optimum surgical outcomes allow minimization of metabolic syndrome,reducing cardiovascular and cerebrovascular risk.

  1. Mechanistic comparison between gastric bypass vs. duodenal switch with sleeve gastrectomy in rat models.

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    Yosuke Kodama

    Full Text Available BACKGROUND: Both gastric bypass (GB and duodenal switch with sleeve gastrectomy (DS have been widely used as bariatric surgeries, and DS appears to be superior to GB. The aim of this study was to better understand the mechanisms leading to body weight loss by comparing these two procedures in experimental models of rats. METHODS: Animals were subjected to GB, DS or laparotomy (controls, and monitored by an open-circuit indirect calorimeter composed of comprehensive laboratory animal monitoring system and adiabatic bomb calorimeter. RESULTS: Body weight loss was greater after DS than GB. Food intake was reduced after DS but not GB. Energy expenditure was increased after either GB or DS. Fecal energy content was increased after DS but not GB. CONCLUSION: GB induced body weight loss by increasing energy expenditure, whereas DS induced greater body weight loss by reducing food intake, increasing energy expenditure and causing malabsorption in rat models.

  2. One Year Follow-up Results after Sleeve Gastrectomy in Type 2 Diabetes Mellitus Patients with Morbid Obesity

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    Dejeu Viorel

    2016-06-01

    Full Text Available Background and aims: Bariatric surgery has been shown to be superior to nonsurgical approaches in terms of weight loss and remission of type 2 diabetes (T2DM and metabolic syndrome. This prospective, single-center, follow-up study assessed percentage of excessive weight loss (%EWL, glycosylated hemoglobin (HbA1c levels, prescribed antidiabetes drugs and diabetes remission rates in obese T2DM patients who underwent laparoscopic sleeve gastrectomy.

  3. CT-Guided Percutaneous Drainage of Infected Collections Due to Gastric Leak After Sleeve Gastrectomy for Morbid Obesity: Initial Experience

    International Nuclear Information System (INIS)

    This study was designed to evaluate the efficacy and safety of computed tomography (CT)-guided drainage in treating infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity. From January 2007 to June 2009, 21 patients (9 men and 12 women; mean age, 39.2 (range, 26–52) years) with infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity underwent image-guided percutaneous drainage. All procedures were performed using CT guidance and 8- to 12-Fr pigtail drainage catheters. Immediate technical success was achieved in all 21 infected collections. In 18 of 21 collections, we obtained progressive shrinkage of the collection with consequent clinical success (success rate 86%). In three cases, the abdominal fluid collection was not resolved, and the patients were reoperated. Among the 18 patients who avoided surgery, 2 needed replacement of the catheter due to obstruction. No major complications occurred during the procedure. The results of our study support that CT-guided percutaneous drainage is an effective and safe method to treat infected abdominal fluid collections due to gastric leak in patients who had previously underwent laparoscopic sleeve gastrectomy for morbid obesity. It may be considered both as a preparatory step for surgery and a valuable alternative to open surgery. Failure of the procedure does not, however, preclude a subsequent surgical operation.

  4. Melanocortin-4 receptor signaling is not required for short-term weight loss after sleeve gastrectomy in pediatric patients.

    Science.gov (United States)

    Jelin, E B; Daggag, H; Speer, A L; Hameed, N; Lessan, N; Barakat, M; Nadler, E P

    2016-03-01

    Homozygous or compound heterozygous melanocortin-4 receptor (MC4R) mutations are rare with fewer than 10 patients described in current literature. Here we report the short- and long-term outcomes for four children ages 4.5-14 who are homozygous for loss-of-function mutations in the MC4R and underwent laparoscopic sleeve gastrectomy. All four patients experienced significant weight loss and improvement in, or resolution of, their comorbidities in the short term. One patient, however, has had significant weight regain in the long term. We conclude that MC4R signaling is not required for short-term weight loss after laparoscopic sleeve gastrectomy in children. Behavior modification may be more important for long-term weight maintenance, but patients with homozygous MC4R deficiency should not be excluded from consideration for sleeve gastrectomy. However, as at least one copy of functional MC4R is necessary and sufficient to induce long-term postoperative weight loss benefits, patients with complete loss of MC4R functionality might be less likely to exhibit the same benefits resulting from bariatric surgery. PMID:26538186

  5. Dry beriberi preceded Wernicke′s encephalopathy: Thiamine deficiency after laparoscopic sleeve gastrectomy

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    Debopam Samanta

    2015-01-01

    Full Text Available In recent times, pediatric obesity has become widely prevalent. If first-line treatment with lifestyle modification fails, bariatric surgery may be indicated for severely obese patients. Many patients now travel abroad to get these surgeries done. Some of these patients receive inadequate postoperative care. We described a morbidly obese 17-year-old girl who had a laparoscopic sleeve gastrectomy procedure for weight loss. Due to severe nausea, she stopped her multivitamin supplementation. Within a few weeks, she developed symptoms of dry beriberi was soon followed by classic symptoms of Wernicke′s encephalopathy. The prompt diagnosis was made with confirmation from serum thiamine level and brain magnetic resonance imaging. Thiamine supplementation reversed ophthalmological symptoms promptly. However, the patient needed inpatient rehabilitation for neuropathy. This case describes that thiamine deficiency can occur after restrictive bariatric surgery, despite lower risk of malnutrition in the absence of intestinal bypass procedure. This report highlights that in the presence of risk factors: dietary noncompliance, inadequate follow-up, and severe nausea with and without vomiting can precipitate the development of Wernicke′s encephalopathy, even after restrictive surgery. Physicians may increasingly encounter thiamine and other nutrient deficiencies in increasing numbers due to increasing prevalence of obesity disorders and availability of bariatric surgeries. This report also emphasized the importance of identifying vague sensory symptoms in thiamine deficiency.

  6. Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Alter the Gut-Brain Communication

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    L. A. Ballsmider

    2015-01-01

    Full Text Available This study investigated the anatomical integrity of vagal innervation of the gastrointestinal tract following vertical sleeve gastrectomy (VSG and Roux-en-Y gastric bypass (RYGB operations. The retrograde tracer fast blue (FB was injected into the stomach to label vagal neurons originating from nodose ganglion (NG and dorsal motor nucleus of the vagus (DMV. Microglia activation was determined by quantifying changes in the fluorescent staining of hindbrain sections against an ionizing calcium adapter binding molecule 1 (Iba1. Reorganization of vagal afferents in the hindbrain was studied by fluorescent staining against isolectin 4 (IB4. The density of Iba1- and IB4-immunoreactivity was analyzed using Nikon Elements software. There was no difference in the number of FB-labeled neurons located in NG and DMV between VSG and VSG-sham rats. RYGB, but not RYGB-sham rats, showed a dramatic reduction in number of FB-labeled neurons located in the NG and DMV. VSG increased, while the RYGB operation decreased, the density of vagal afferents in the nucleus tractus solitarius (NTS. The RYGB operation, but not the VSG procedure, significantly activated microglia in the NTS and DMV. Results of this study show that the RYGB, but not the VSG procedure, triggers microglia activation in vagal structures and remodels gut-brain communication.

  7. The Initial Learning Curve for Robot-Assisted Sleeve Gastrectomy: A Surgeon's Experience While Introducing the Robotic Technology in a Bariatric Surgery Department.

    Science.gov (United States)

    Vilallonga, Ramon; Fort, José Manuel; Gonzalez, Oscar; Caubet, Enric; Boleko, Angeles; Neff, Karl John; Armengol, Manel

    2012-01-01

    Objective. Robot-assisted sleeve gastrectomy has the potential to treat patients with obesity and its comorbidities. To evaluate the learning curve for this procedure before undergoing Roux en-Y gastric bypass is the objective of this paper. Materials and Methods. Robot-assisted sleeve gastrectomy was attempted in 32 consecutive patients. A survey was performed in order to identify performance variables during completion of the learning curve. Total operative time (OT), docking time (DT), complications, and length of hospital stay were compared among patients divided into two cohorts according to the surgical experience. Scattergrams and continuous curves were plotted to develop a robotic sleeve gastrectomy learning curve. Results. Overall OT time decreased from 89.8 minutes in cohort 1 to 70.1 minutes in cohort 2, with less than 5% change in OT after case 19. Time from incision to docking decreased from 9.5 minutes in cohort 1 to 7.6 minutes in cohort 2. The time required to dock the robotic system also decreased. The complication rate was the same in the two cohorts. Conclusion. Our survey indicates that technique and outcomes for robot-assisted sleeve gastrectomy gradually improve with experience. We found that the learning curve for performing a sleeve gastrectomy using the da Vinci system is completed after about 20 cases.

  8. Clinical implications of sleeve gastrectomy as a source of spleen infarction or ischemia.

    Science.gov (United States)

    Stamou, Konstantinos M; Menenakos, Evangelos; Gomatos, Ilias P; Panousopoulos, Sotirios-George D; Smparounis, Spyridon; Leandros, Emmanuel; Zografos, George

    2011-10-01

    Splenic arterial demarcation has been observed during laparoscopic sleeve gastrectomy (LSG). The present study aims to detect its actual incidence during LSG and clarify its clinical significance. This is a prospective observational study of 287 consecutive patients that underwent LSG by the same surgical team over 3 years. In all patients, the gastric fundus was mobilized using a standard technique. Before withdrawal of the pneumoperitoneum, the spleen was exposed and carefully inspected for evidence of arterial demarcation. Patients with a clear demarcation were followed with Doppler ultrasound. Computed tomography scan with oral contrast was performed to rule out septic complications. Median preoperative body mass index was 46 kg/m(2) (range 35.1-78). Median operative time was 58 min (range 42-185), median hospital stay was 3 days (range 3-45), and overall morbidity rate was 8.6%. Intraoperative demarcation of the upper splenic pole was evident in 12 patients (4.1%). Eleven patients had uneventful postoperative course. One patient raised temperature of 38.5°C at the 7th postoperative day and was readmitted for further treatment. Once afebrile, the patient was discharged on the 10th postoperative day and continued on prophylactic low molecular weight heparin (tinzaparin, 7,500 U sc.) for 20 days. Splenic discoloration following LSG is an uncommon complication with minimal clinical significance, which could be related to hematoma, venous congestion, or ischemia. The possibility of a late splenic abscess cannot be ruled out. No risk factors can be identified preoperatively.

  9. Influence of Sleeve Gastrectomy on NASH and Type 2 Diabetes Mellitus

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    W. K. Karcz

    2011-01-01

    Full Text Available Background. Nonalcoholic fatty liver disease is present in up to 85% of adipose patients and may proceed to nonalcoholic steatohepatitis (NASH. With insulin resistance and obesity being the main risk factors for NASH, the effect of isolated sleeve gastrectomy (ISG on these parameters was examined. Methods. 236 patients underwent ISG with intraoperative liver biopsy from December 2002 to September 2009. Besides demographic data, pre-operative weight/BMI, HbA1c, AST, ALT, triglycerides, HDL and LDL levels were determined. Results. A significant correlation of NASH with higher HbA1c, AST and ALT and lower levels for HDL was observed (P<.05, <.0001, <.0001, <.01, resp.. Overall BMI decreased from 45.0 ± 6.8 to 29.7 ± 6.5 and 31.6 ± 4.4 kg/m2 at 1 and 3 years. An impaired weight loss was demonstrated for patients with NASH and patients with elevated HbA1c (plateau 28.08 kg/m2 versus 29.79 kg/m2 and 32.30 kg/m2 versus 28.79 kg/m2, resp.. Regarding NASH, a significant improvement of AST, ALT, triglyceride and HDL levels was shown (P<.0001 for all. A resolution of elevated HbA1c was observed in 21 of 23 patients. Summary. NASH patients showed a significant loss of body weight and amelioration of NASH status. ISG can be successfully performed in these patients and should be recommended for this subgroup.

  10. Vertical Sleeve Gastrectomy Improves Glucose and Lipid Metabolism and Delays Diabetes Onset in UCD-T2DM Rats

    OpenAIRE

    Cummings, Bethany P.; Bettaieb, Ahmed; Graham, James L; Stanhope, Kimber L.; Kowala, Mark; Haj, Fawaz G.; Chouinard, Michael L.; Peter J Havel

    2012-01-01

    Vertical sleeve gastrectomy (VSG) has gained interest as a low morbidity bariatric surgery, which is effective in producing weight loss and causing type 2 diabetes resolution. However, the efficacy of VSG to prevent the onset of type 2 diabetes has not been previously investigated. VSG or sham surgery was performed on 2-month-old prediabetic male University of California Davis-type 2 diabetes mellitus rats. Sham-operated animals were either sham-operated ad libitum fed (S-AL) or were weight-m...

  11. Robotically Assisted Single Anastomosis Duodenoileal Bypass after Previous Sleeve Gastrectomy Implementing High Valuable Technology for Complex Procedures

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    Ramon Vilallonga

    2015-01-01

    Full Text Available Staged bariatric procedures in high risk patients are a common used strategy for morbid obese patients nowadays. After previous sleeve gastrectomy, surgical treatments in order to complete weight loss or comorbidities improvements or resolutions are possible. One strategy is to perform a novel technique named SADI (single anastomosis duodenoileal bypass-sleeve. We present the technique for totally intracorporeal robotically assisted SADI using five ports and a liver retractor. We aim to see if the robotic technology offers more advantageous anastomosis and dissection obtained by the robotic approach in comparison to standard laparoscopy. The safety, feasibility, and reproducibility of a minimally invasive robotic surgical approach to complex abdominal operations such as SADI are discussed.

  12. Ileal interposition with sleeve gastrectomy for treatment of type 2 diabetes mellitus

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    Sunil Kumar Kota

    2012-01-01

    Full Text Available Aim: Combination of laparoscopic ileal interposition (II with sleeve gastrectomy (SG is an upcoming procedure, which offers good metabolic improvement and weight reduction without causing significant malabsorption. The objective of this study was to evaluate the results of this novel procedure for control of type 2 diabetes, obesity, hypertension, and related metabolic abnormalities. Materials and Methods: The II and SG was performed in 43 patients (M:F = 25:18 from February 2008. Participants had a mean age of 47.2 ± 8.2 years (range 29-66 years, mean duration of diabetes of 10.1 ± 9.2 years (range 1-32 years, and mean preoperative body mass index (BMI of 33.2 ± 7.8 kg/m2. All patients had poorly controlled type 2 diabetes mellitus (DM [mean glycated hemoglobin (HbA1C 9.6 ± 2.1%] despite use of oral hypoglycemic agents (OHAs and/or insulin. Thirty (70% patients had hypertension, 20 (46% had dyslipidemia, and 18 (42% had significant microalbuminuria. The primary outcome was remission of diabetes (HbA1C < 6.5% without OHAs/insulin and the secondary outcomes were reduction in antidiabetic agent requirement and components of metabolic syndrome. Results: Mean follow-up was for 20.2 ± 8.6 months (range 4-40 months. Postoperatively, glycemic parameters (fasting and post-lunch blood sugar, HbA1C improved in all patients (P < 0.05 at all intervals. Twenty (47% patients had remission in diabetes and the remaining patients showed significantly decreased OHA requirement. All patients had weight loss between 15 and 30% (P < 0.05. Twenty-seven (90% patients had remission in hypertension. At 3 years, the mean fall in HbA1C (34% was more than reduction in BMI (25%. There was a declining trend in lipids and microalbuminuria postoperatively, though it was significant for microalbuminuria only. Conclusions: The laparoscopic II with SG seems to be a promising procedure for control of type 2 DM, hypertension, weight reduction, and associated metabolic

  13. Optical Coherence Tomography Parameters in Morbidly Obese Patients Who Underwent Laparoscopic Sleeve Gastrectomy

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    Berna Dogan

    2016-01-01

    Full Text Available Purpose. To investigate changes in optical coherence tomography parameters in morbidly obese patients who had undergone laparoscopic sleeve gastrectomy (LSG. Methods. A total of 41 eyes of 41 morbidly obese patients (BMI ≥ 40 who had undergone LSG were included in study. The topographic optic disc parameters, central macular thickness (CMT, total macular volume (TMV, and retinal ganglion cell layer (RGCL were measured by spectral-domain optical coherence tomography (SD-OCT. Subfoveal choroidal thickness (SFCT was measured by enhanced deep imaging-optical coherence tomography (EDI-OCT. Results. The mean CMT was 237.4±24.5 μm, 239.3±24.1 μm, and 240.4±24.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean TMV was 9.88±0.52 mm3, 9.96±0.56 mm3, and 9.99±0.56 mm3 preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean RGCL was 81.2±6.5 μm, 82.7±6.6 μm, and 82.9±6.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. The mean SFCT was 309.8±71.8 μm, 331.0±81.4 μm, and 352.7±81.4 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p<0.01. No statistically significant differences were found between the preoperative values and 3- and 6-month postoperative values in rim area (p=0.34, disc area (p=0.64, vertical cup/disc ratio (p=0.39, cup volume (p=0.08, or retinal nerve fiber layer (p=0.90. Conclusions. Morbidly obese patients who undergo LSG experience a statistically significant increase in CMT, TMV, SFCT, and RGCL at 3 months and 6 months after surgery.

  14. Achalasia: A case report on its effect during surgical decision making for laparoscopic sleeve gastrectomy in the young morbidly obese patient

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    Rodolfo J. Oviedo, MD, FACS

    2016-01-01

    Conclusion: The patient has already undergone a POEM procedure, which was chosen to maintain the gastric fundus, cardia, and gastroesophageal junction (GEJ architecture as opposed to a LHM with Dor fundoplication, which would have altered the anatomy, thus making a concomitant laparoscopic sleeve gastrectomy an unfeasible option.

  15. Insulin Resistance, Microbiota, and Fat Distribution Changes by a New Model of Vertical Sleeve Gastrectomy in Obese Rats.

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    Basso, Nicola; Soricelli, Emanuele; Castagneto-Gissey, Lidia; Casella, Giovanni; Albanese, Davide; Fava, Francesca; Donati, Claudio; Tuohy, Kieran; Angelini, Giulia; La Neve, Federica; Severino, Anna; Kamvissi-Lorenz, Virginia; Birkenfeld, Andrea L; Bornstein, Stefan; Manco, Melania; Mingrone, Geltrude

    2016-10-01

    Metabolic surgery improves insulin resistance and type 2 diabetes possibly because of weight loss. We performed a novel sleeve gastrectomy in rats that resects ∼80% of the glandular portion, leaving the forestomach almost intact (glandular gastrectomy [GG]) and compared subsequent metabolic remodeling with a sham operation. GG did not affect body weight, at least after 10 weeks; improved hepatic and peripheral insulin sensitivity likely through increased Akt, glycogen synthase kinase 3, and AMPK phosphorylation; and reduced ectopic fat deposition and hepatic glycogen overaccumulation. Body adipose tissue was redistributed, with reduction of intraabdominal fat. We found a reduction of circulating ghrelin levels, increased GLP-1 plasma concentration, and remodeling of gut microbiome diversity characterized by a lower relative abundance of Ruminococcus and a higher relative abundance of Lactobacillus and Collinsella These data suggest that at least in rat, the glandular stomach plays a central role in the improvement of insulin resistance, even if obesity persists. GG provides a new model of the metabolically healthy obese phenotype.

  16. Case report: Renal infarction by paradoxical embolism through the patent foramen ovale as an unusual cause of post-operative abdominal pain after sleeve gastrectomy

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    Oleksandr Khoma, Dr

    2016-01-01

    Full Text Available 50-year-old female presented with abdominal pain 9 days post sleeve gastrectomy and was found to have acute renal infarction caused by paradoxical emboli through patent foramen ovale (PFO as a cause of the renal infarction. Renal infarctions caused by paradoxical embolism are rare and have not been previously reported following surgery, bariatric surgery in particular. This report describes presentation, work up and management of a patient with renal infarct following bariatric surgery.

  17. The different effects of gastric banding and sleeve gastrectomy on obese rat%胃束带术和袖状胃切除术对营养性肥胖大鼠干预效果差异的研究

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    梁永康; 王兵

    2012-01-01

    Objective To evaluate the different effects of gastric banding (GB) and sleeve gastrectomy (SG) on diet-induced obese rat model.Methods The obese rat model was established via the diet-induced method,and then underwent SG,GB,or sham-operation (SO) procedures.The different effects of SG,GB,and SO on these rats were evaluated at the 14th,28th and 56th day after operation.Results After 7 weeks' feeding,31rats in high-diet group reached the modeling standard.The model success rate was 88.6% (31/35).GB and SG group showed significantly less cumulative food intake than SO group ( P < 0.01).There was no significant difference between GB and SG group in cumulative food intake ( P > 0.05 ).The average weight of rats in GB and SG group was (609.1±6.0) g and (591.6 ±4.3) g respectively at the 56th day after operation while it was (649.8 ± 10.0) g for SO group.The difference had statistical significance ( P < 0.01).SG group showed better improvement effects on TC,TG,FFA,LDL-c and HDL-c than GB group (P <0.05).The postoperative ghrelin level in GB and SG group all decreased constantly and it decreased slower in GB group than in SG group.At the 56th day after operation,the ghrelin level in GB and SG group reduced from (1151.0 ± 144.2) pg/ml and (1148.2±127.2) pg,/ml to (992.0+121.9) pg/ml (P<0.05) and (761.0+125.3) pg/ml (P<0.01) respectively.The leptin level in GB and SG group all showed decreasing tendency.However,the leptin level of the 2 groups presented significant difference at the 56th day after operation.Conclusions There is no significant difference between GB and SG group in postoperative cumulative food intake.However,SG has better effects on controlling weight gain and improving blood lipids than GB.The different effects of GB and SG on the level of ghrelin and leptin in rats may account for the different curative effects.%目的 探讨胃束带术(GB)和袖状胃切除术(SG)对营养性肥胖大鼠疗效的差异.方法 对饮食诱导方法建

  18. A rare cause of bleeding after laparoscopic sleeve gastrectomy : pseudo-aneurysm of the gastro-omental artery.

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    Mege, D; Louis, G; Berthet, B

    2013-01-01

    A serious complication of laparoscopic sleeve gastrectomy (LSG) is bleeding that is primarily located along the staples lines. Bleeding may be due to several causes, including hematomas, trocar sites, or visceral pseudo-aneurysms. We reported here a case of bleeding related to a pseudo-aneurysm of the gastro-omental artery. An LSG was performed on a 43-year-old woman (BMI = 46 kg/m2) without apparent surgical complications. Fifteen days later, she was admitted to the emergency department for hematemesis and symptoms of hemorrhagic shock. Abdominal computed tomography angiography revealed blood in the stomach, without a digestive leak, and active bleeding from a pseudo-aneurysm of the gastro-omental artery. An arterial embolisation was performed with the sandwich technique and angiographic guide wires and the placement of several detachable coils. The patient was discharged two days later. We demonstrated for the first time that post-LSG bleeding may involve a pseudo-aneurysm of the gastro-omental artery.

  19. A Case Study of Severe Esophageal Dysmotility following Laparoscopic Sleeve Gastrectomy.

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    Sheppard, Caroline E; Sadowski, Daniel C; Gill, Richdeep; Birch, Daniel W

    2016-01-01

    Following bariatric surgery, a proportion of patients have been observed to experience reflux, dysphagia, and/or odynophagia. The etiology of this constellation of symptoms has not been systematically studied to date. This case describes a 36-year-old female with severe esophageal dysmotility following LSG. Many treatments had been used over a course of 3 years, and while calcium channel blockers reversed the esophageal dysmotility seen on manometry, significant symptoms of dysphagia persisted. Subsequently, the patient underwent a gastric bypass, which seemed to partially relieve her symptoms. Her dysphagia was no longer considered to be associated with a structural cause but attributed to a "sleeve dysmotility syndrome." Considering the difficulties with managing sleeve dysmotility syndrome, it is reasonable to consider the need for preoperative testing. The question is whether motility studies should be required for all patients planning to undergo a LSG to rule out preexisting esophageal dysmotility and whether conversion to gastric bypass is the preferred method for managing esophageal dysmotility after LSG. PMID:27413570

  20. Evaluation of laparoscopic sleeve gastrectomy compared with laparoscopic Roux-en-Y gastric bypass for people with morbid obesity: A systematic review and meta-analysis

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    Arabi Basharic, Fateme; Olyaee Manesh, Alireza; Ranjbar Ezzat Abadi, Mohammad; Shiryazdi, Seyed Mostafa; Shabahang, Hussein; Jangjoo, Ali

    2016-01-01

    Background: Prevalence of obesity in the world, in both developed and developing countries, is growing rapidly. Bariatric surgery is now accepted as the treatment for morbid obesity. Objective: This study compares laparoscopic sleeve gastrectomy's effectiveness (LSG) with the most common bariatric surgery, laparoscopic Roux-en-Y (LRYGB) gastric bypass. Methods: A systematic review was performed using relevant search data bases, including Cochrane library, PubMed, Magi ran, Iranmedex, SID and Trip database, with no time limit. Data bases were searched until July 2014 for randomized control trials. The studied population included people aged between 18–60 years, with BMI≥35 and at least one obesity-related disease, or people with BMI≥40. BMI change, as the research outcome, was investigated at least in one-year follow-up period. Cochrane criteria were used to assess quality of studies. The results were extracted from the articles. Results: In total, 384 articles were obtained in the search; six RCTs were included in this study. There was no significant difference between the two laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass procedures in BMI, and both groups were similar in weight loss CI [-.1.31, 0.43], p=0.32. Conclusion: The two procedures of bariatric surgery are effective and reliable treatments. Performing more trial studies with greater sample size and longer follow-up period for making final decision in selecting a certain surgical procedure is essential.

  1. 袖状胃切除术治疗重度肥胖症进展%New progresses of sleeve gastrectomy for morbid obesity

    Institute of Scientific and Technical Information of China (English)

    邢颖; 白日星

    2014-01-01

    随着肥胖人群的增加,减肥手术的应用逐渐广泛,袖状胃切除术作为一种相对较新的术式,由于其术式简单,手术风险小且效果良好,近年来受到了越来越多的减肥外科医师和肥胖患者关注。本文从患者选择、手术技巧、效果、并发症等方面介绍袖状胃切除术的最新进展。%Bariatric surgery is used more and more widely as the population of obesity is increasing, sleeve gastrectomy is a relatively new kind of bariatric surgery, which grows more popular for its perceived technical simplicity, feasibility, and good outcomes. This article introduces new progresses of sleeve gastrectomy in patient selection, surgical technique, effectiveness, and complications.

  2. Influence of sleeve gastrectomy on glycometabolism%袖状胃切除术对糖代谢的影响

    Institute of Scientific and Technical Information of China (English)

    严玲玲; 朱占勇; 吴丹; 吴毅平

    2011-01-01

    Objective To explore the effect of sleeve gastrectomy (SG) on glycometaholism with several experimental metaholic models. Methods Ohesity rats induced by high-fat diet (F group) , GK rats (G group) and Non-obese Wistar rats (control group) were underwent SG and the variation of weight reduction, foodintake,plasama ghrelin, insulin, GLP-1 , glycemia were compared in three groups. Results Compared with control group, F and D groups showed effective weight loss and anorexic effects , improvent in glycemia with increased insuli level during eight weeks postsurgery (P < 0.05) , The F and D groups exhibited significantly decreased levels of plasma ghrelin and elevated levels of plasma GLP-1 (P < 0.05). Conclusion SG was represented an effective way of improvement glycometaholism and lipid metaholism on several experimental metabolic models.%目的:通过建立几种不同袖状胃切除模型,探讨袖状胃切除术对糖代谢的影响.方法:分别在肥胖诱导大鼠(F组)、糖尿病GK鼠(D组)、普通Wistar大鼠(C组)建立袖状胃切除模型,术后连续观察8周,比较3组术后体重、摄食和外周血活性Ghrelin、GLP-1、胰岛素及血糖浓度的变化.结果:与C组相比,F组大鼠与D组大鼠体重下降且摄食量减少,血糖改善(P < 0.05),F组大鼠与D组大鼠外周血活性Ghrelin浓度下降,GLP-1浓度升高(P < 0.05).结论:袖状胃切除术在肥胖及2型糖尿病大鼠模型上能有效改善糖代谢.

  3. Comparison of weight loss outcomes 1 year after sleeve gastrectomy and Roux-en-Y gastric bypass in patients aged above 50 years

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    Palanivelu Praveenraj

    2016-01-01

    Full Text Available Introduction: Safe, effective weight loss with resolution of comorbidities has been convincingly demonstrated with bariatric surgery in the aged obese. They, however, lose less weight than younger individuals. It is not known if degree of weight loss is influenced by the choice of bariatric procedure. The aim of this study was to compare the degree of weight loss between laparoscopic sleeve gastrectomy (LSG and laparoscopic Roux-en-Y gastric bypass (LRYGB in patients above the age of 50 years at 1 year after surgery. Materials and Methods: A retrospective analysis was performed of all patients more than 50 years of age who underwent LSG or LRYGB between February 2012 and July 2013 with at least 1 year of follow-up. Data evaluated at 1 year included age, sex, weight, body mass index (BMI, mean operative time, percentage of weight loss and excess weight loss, resolution/remission of diabetes, morbidity and mortality. Results: Of a total of 86 patients, 54 underwent LSG and 32 underwent LRYGB. The mean percentage of excess weight loss at the end of 1 year was 60.19 ± 17.45 % after LSG and 82.76 ± 34.26 % after LRYGB (P = 0.021. One patient developed a sleeve leak after LSG, and 2 developed iron deficiency anaemia after LRYGB. The remission/improvement in diabetes mellitus and biochemistry was similar. Conclusion: LRYGB may offer better results than LSG in terms of weight loss in patients over 50 years of age.

  4. Comparison of weight loss outcomes 1 year after sleeve gastrectomy and Roux-en-Y gastric bypass in patients aged above 50 years

    Science.gov (United States)

    Praveenraj, Palanivelu; Gomes, Rachel M; Kumar, Saravana; Perumal, Sivalingam; Senthilnathan, Palanisamy; Parthasarathi, Ramakrishnan; Rajapandian, Subbiah; Palanivelu, Chinnusamy

    2016-01-01

    INTRODUCTION: Safe, effective weight loss with resolution of comorbidities has been convincingly demonstrated with bariatric surgery in the aged obese. They, however, lose less weight than younger individuals. It is not known if degree of weight loss is influenced by the choice of bariatric procedure. The aim of this study was to compare the degree of weight loss between laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients above the age of 50 years at 1 year after surgery. MATERIALS AND METHODS: A retrospective analysis was performed of all patients more than 50 years of age who underwent LSG or LRYGB between February 2012 and July 2013 with at least 1 year of follow-up. Data evaluated at 1 year included age, sex, weight, body mass index (BMI), mean operative time, percentage of weight loss and excess weight loss, resolution/remission of diabetes, morbidity and mortality. RESULTS: Of a total of 86 patients, 54 underwent LSG and 32 underwent LRYGB. The mean percentage of excess weight loss at the end of 1 year was 60.19 ± 17.45 % after LSG and 82.76 ± 34.26 % after LRYGB (P = 0.021). One patient developed a sleeve leak after LSG, and 2 developed iron deficiency anaemia after LRYGB. The remission/improvement in diabetes mellitus and biochemistry was similar. CONCLUSION: LRYGB may offer better results than LSG in terms of weight loss in patients over 50 years of age. PMID:27279392

  5. Management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity: A tertiary care experience and design of a management algorithm

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    Praveenraj, Palanivelu; Gomes, Rachel M; Kumar, Saravana; Senthilnathan, Palanisamy; Parthasarathi, Ramakrishnan; Rajapandian, Subbiah; Palanivelu, Chinnusamy

    2016-01-01

    BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed ‘standalone’ bariatric procedure in India. Staple line gastric leaks occur infrequently but cause significant and prolonged morbidity. The aim of this retrospective study was to analyse the management of patients with a gastric leak after LSG for morbid obesity at our institution. PATIENTS AND METHODS: From February 2008 to 2014, 650 patients with different degrees of morbid obesity underwent LSG. Among these, all those diagnosed with a gastric leak were included in the study. Patients referred to our institution with gastric leak after LSG were also included. The time of presentation, site of leak, investigations performed, treatment given and time of closure of all leaks were analysed. RESULTS: Among the 650 patients who underwent LSG, 3 (0.46%) developed a gastric leak. Two patients were referred after LSG was performed at another institution. The mean age was 45.60 ± 15.43 years. Mean body mass index (BMI) was 44.79 ± 5.35. Gastric leak was diagnosed 24 h to 7 months after surgery. One was early, two were intermediate and two were late leaks. Two were type I and three were type II gastric leaks. Endoscopic oesophageal stenting was used variably before or after re-surgery. Re-surgery was performed in all and included stapled fistula excision (re-sleeve), suture repair only or with conversion to roux-en-Y gastric bypass or fistula jujenostomy. There was no mortality. CONCLUSION: Leakage closure time may be shorter with intervention than expectant management. Sequence and choice of endoscopic oesophageal stenting and/or surgical re-intervention should be individualized according to clinical presentation. PMID:27251808

  6. Management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity: A tertiary care experience and design of a management algorithm

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    Palanivelu Praveenraj

    2016-01-01

    Full Text Available Background: Laparoscopic sleeve gastrectomy (LSG is the most commonly performed 'standalone' bariatric procedure in India. Staple line gastric leaks occur infrequently but cause significant and prolonged morbidity. The aim of this retrospective study was to analyse the management of patients with a gastric leak after LSG for morbid obesity at our institution. Patients and Methods: From February 2008 to 2014, 650 patients with different degrees of morbid obesity underwent LSG. Among these, all those diagnosed with a gastric leak were included in the study. Patients referred to our institution with gastric leak after LSG were also included. The time of presentation, site of leak, investigations performed, treatment given and time of closure of all leaks were analysed. Results: Among the 650 patients who underwent LSG, 3 (0.46% developed a gastric leak. Two patients were referred after LSG was performed at another institution. The mean age was 45.60 ± 15.43 years. Mean body mass index (BMI was 44.79 ± 5.35. Gastric leak was diagnosed 24 h to 7 months after surgery. One was early, two were intermediate and two were late leaks. Two were type I and three were type II gastric leaks. Endoscopic oesophageal stenting was used variably before or after re-surgery. Re-surgery was performed in all and included stapled fistula excision (re-sleeve, suture repair only or with conversion to roux-en-Y gastric bypass or fistula jujenostomy. There was no mortality. Conclusion: Leakage closure time may be shorter with intervention than expectant management. Sequence and choice of endoscopic oesophageal stenting and/or surgical re-intervention should be individualized according to clinical presentation.

  7. Laparoscopic sleeve gastrectomy for morbid obesity with intra-operative endoscopic guidance. Immediate peri-operative and 1-year results after 25 patients.

    Science.gov (United States)

    Diamantis, T; Alexandrou, A; Pikoulis, E; Diamantis, D; Griniatsos, J; Felekouras, E; Papalambros, E

    2010-08-01

    Laparoscopic sleeve gastrectomy (LSG) represents a promising alternative option for the surgical treatment of morbid obesity. Its standard technique includes the longitudinal division of the stomach along a bougie of varying diameter. We report in this retrospective study our experience with LSG being performed with the use of intra-operative endoscopy instead of the bougie. Twenty-five consecutive patients (18 women, seven men) with a mean age of 40.2 years and mean body weight of 152.1 kg were submitted to LSG with intra-operative endoscopy in our hospital. The mean preoperative BMI was 53.5 kg/m(2). There were no conversions. Mean operative time was 117.5 min. There was no morbidity or mortality. The mean loss of excess body weight (EBW) at 3 months post-op was 19 +/- 1.8 kg, at 6 months was 28.6 +/- 4.5 kg, and at 1 year post-op was 48.9 +/- 3.7 kg (min 11-max 92). In other words the patients had lost 30 +/- 5%, 45 +/- 7.7%, and 60.8 +/- 4.3% of their EBW, respectively. The mean excess body weight loss at the day of the last visit to our outpatient clinic was 52.3 +/- 4.3 kg which corresponded to 66.4 +/- 4.3% of the total excess weight. LSG with intra-operative endoscopic guidance is a safe and efficient alternative method to treat morbid obesity and is a viable option for surgical units familiar with endoscopic techniques. PMID:20464526

  8. IFN-γ secretion in gut of Ob/Ob mice after vertical sleeve gastrectomy and its function in weight loss mechanism.

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    Du, Jin-Peng; Wang, Geng; Hu, Chao-Jie; Wang, Qing-Bo; Li, Hui-Qing; Xia, Wen-Fang; Shuai, Xiao-Ming; Tao, Kai-Xiong; Wang, Guo-Bin; Xia, Ze-Feng

    2016-06-01

    Vertical sleeve gastrectomy (VSG) is becoming more and more popular among the world. Despite its dramatic efficacy, however, the mechanism of VSG remains largely undetermined. This study aimed to test interferon (IFN)-γ secretion n of mesenteric lymph nodes in obese mice (ob/ob mice), a model of VSG, and its relationship with farnesoid X receptor (FXR) expression in the liver and small intestine, and to investigate the weight loss mechanism of VSG. The wild type (WT) mice and ob/ob mice were divided into four groups: A (WT+Sham), B (WT+VSG), C (ob/ob+Sham), and D (ob/ob+VSG). Body weight values were monitored. The IFN-γ expression in mesenteric lymph nodes of ob/ob mice pre- and post-operation was detected by flow cytometry (FCM). The FXR expression in the liver and small intestine was detected by Western blotting. The mouse AML-12 liver cells were stimulated with IFN-γ at different concentrations in vitro. The changes of FXR expression were also examined. The results showed that the body weight of ob/ob mice was significantly declined from (40.6±2.7) g to (27.5±3.8) g on the 30th day after VSG (Psecretion of IFN-γ in mesenteric lymph nodes of ob/ob mice than that pre-operation (Psmall intestine after VSG were respectively 0.97±0.07 and 0.84±0.07 fold of GAPDH, which were significantly higher than pre-operative levels of 0.50±0.06 and 0.48±0.06 respectively (Psecretion of mesenteric lymph nodes, which then increases the FXR expression of the liver and small intestine.

  9. Laparoscopic Sleeve Gastrectomy for Mildly Obese Patients (Body Mass Index of 30 <35 kg/m2: Operative Outcome and Short-Term Results

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    Roger Noun

    2012-01-01

    Full Text Available Background. Data concerning laparoscopic sleeve gastrectomy (LSG in mild obesity are under investigation. Aim/Objective. May 2010 to May 2012, 122 consecutive patients with preoperative body mass index (BMI of 33±2.5 kg/m2 (range 30–34.9 undergoing LSG were studied. Mean age was 33±10 years (range 15–60, and 105 (86% were women. Mean preoperative weight was 91±9.7 kg (range 66–121, and preoperative excess weight was 30±6.7 kg (range 19–43. Comorbidities were detected in 44 (36% patients. Results. Mean operative time was 58±15 min (range 40–95, and postoperative stay was 1.8±0.19 days (range 1.5–3. There were no admissions to intensive care unit and no deaths within 30 days of surgery. The rates of leaks and strictures were 0%, and of hemorrhage 1.6%. At 12 months, BMI decreased to 24.7±2, and the percentage of excess weight loss (% EWL reached 76.5%. None of the patients had a BMI below 20 kg/m2. Comorbidities resolved in 70.5% or improved in 29.5%. Patient satisfaction scoring (1–5 at least 1 year after was 4.6±0.8 for body image and 4.4±0.6 for food tolerance. Conclusion. LSG for mildly obese patients has proved to be technically relatively easy, safe, and benefic in the short term.

  10. Lower fetuin-A, retinol binding protein 4 and several metabolites after gastric bypass compared to sleeve gastrectomy in patients with type 2 diabetes.

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    Mia Jüllig

    Full Text Available BACKGROUND: Bypass of foregut secreted factors promoting insulin resistance is hypothesized to be one of the mechanisms by which resolution of type 2 diabetes (T2D follows roux-en-y gastric bypass (GBP surgery. AIM: To identify insulin resistance-associated proteins and metabolites which decrease more after GBP than after sleeve gastrectomy (SG prior to diabetes remission. METHODS: Fasting plasma from 15 subjects with T2D undergoing GBP or SG was analyzed by proteomic and metabolomic methods 3 days before and 3 days after surgery. Subjects were matched for age, BMI, metformin therapy and glycemic control. Insulin resistance was calculated using homeostasis model assessment (HOMA-IR. For proteomics, samples were depleted of abundant plasma proteins, digested with trypsin and labeled with iTRAQ isobaric tags prior to liquid chromatography-tandem mass spectrometry analysis. Metabolomic analysis was performed using gas chromatography-mass spectrometry. The effect of the respective bariatric surgery on identified proteins and metabolites was evaluated using two-way analysis of variance and appropriate post-hoc tests. RESULTS: HOMA-IR improved, albeit not significantly, in both groups after surgery. Proteomic analysis yielded seven proteins which decreased significantly after GBP only, including Fetuin-A and Retinol binding protein 4, both previously linked to insulin resistance. Significant decrease in Fetuin-A and Retinol binding protein 4 after GBP was confirmed using ELISA and immunoassay. Metabolomic analysis identified significant decrease of citrate, proline, histidine and decanoic acid specifically after GBP. CONCLUSION: Greater early decrease was seen for Fetuin-A, Retinol binding protein 4, and several metabolites after GBP compared to SG, preceding significant weight loss. This may contribute to enhanced T2D remission observed following foregut bypass procedures.

  11. Remodeling of the residual gastric mucosa after roux-en-y gastric bypass or vertical sleeve gastrectomy in diet-induced obese rats.

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    Konstantinos Arapis

    Full Text Available Whereas the remodeling of intestinal mucosa after bariatric surgeries has been the matter of numerous studies to our knowledge, very few reported on the remodeling of the residual gastric mucosa. In this study, we analyzed remodeling of gastric mucosa after Roux-en-Y gastric bypass (RYGB and vertical sleeve gastrectomy (VSG in rats. Diet-induced obese rats were subjected to RYGB, VSG or sham surgical procedures. All animals were assessed for food intake, body-weight, fasting blood, metabolites and hormones profiling, as well as insulin and glucose tolerance tests before and up to 5 weeks post-surgery. Remodeling of gastric tissues was analyzed by routine histology and immunohistochemistry studies, and qRT-PCR analyses of ghrelin and gastrin mRNA levels. In obese rats with impaired glucose tolerance, VSG and RYGB caused substantial weight loss and rats greatly improved their oral glucose tolerance. The remaining gastric mucosa after VSG and gastric pouch (GP after RYGB revealed a hyperplasia of the mucous neck cells that displayed a strong immunoreactivity for parietal cell H+/K+-ATPase. Ghrelin mRNA levels were reduced by 2-fold in remaining fundic mucosa after VSG and 10-fold in GP after RYGB. In the antrum, gastrin mRNA levels were reduced after VSG in line with the reduced number of gastrin positive cells. This study reports novel and important observations dealing with the remaining gastric mucosa after RYGB and VSG. The data demonstrate, for the first time, a hyperplasia of the mucous neck cells, a transit cell population of the stomach bearing differentiating capacities into zymogenic and peptic cells.

  12. 腹腔镜袖状胃切除术在减重与代谢外科中应用的评价%Evaluation of the application of laparoscopic sleeve gastrectomy in bariatric and metabolic surgery

    Institute of Scientific and Technical Information of China (English)

    许博; 姚琪远

    2013-01-01

    Bariatric surgery is one of the most effective treatment options for obesity and type 2 diabetes mellitus.In recent years,laparoscopic sleeve gastrectomy has become increasingly popular due to simple operation,high safety and significant efficacy.In this article,the progress and the application evaluation of laparoscopic sleeve gastrectomy for the treatment of obesity and type 2 diabetes mellitus in the field of bariatric and metabolic surgery are reviewed.%大量临床资料证明,减重-代谢手术是治疗肥胖及2型糖尿病长期有效的方法.其中腹腔镜袖状胃切除术由于操作简便、安全性高且疗效明显,近年来得到了迅速普及.随着相关研究的开展,减重与代谢外科领域对该术式的认识逐渐深入.本文就腹腔镜袖状胃切除术在减重与代谢外科中的应用现状做一文献综述.

  13. Comparing Outcomes of Two Types of Bariatric Surgery in an Adolescent Obese Population: Roux-en-Y Gastric Bypass versus Sleeve Gastrectomy

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    Giovana D Maffazioli

    2016-07-01

    Full Text Available Background: Obesity is prevalent among adolescents and is associated with serious health consequences. Roux-en-Y Gastric Bypass (RYGB and Sleeve Gastrectomy (SG are bariatric procedures that cause significant weight loss in adults and are increasingly being performed in adolescents with morbid obesity. Data comparing outcomes of RYGB versus SG in this age-group are scarce. This study aims to compare short-term (1-6 months and longer-term (7-18 months body mass index (BMI and biochemical outcomes following RYGB and SG in adolescents/young adults.Methods: A retrospective study using data extracted from medical records of patients 16-21 years who underwent RYGB or SG between 2012-2014 at a tertiary care academic medical center. Results: Forty-six patients were included in this study: 24 underwent RYGB and 22 underwent SG. Groups did not differ for baseline age, sex, race or BMI. BMI reductions were significant at 1-6 months and 7-18 months within groups (p<0.0001, but did not differ by surgery type (p= 0.65 and 0.09, for 1-6 months and 7-18 months, respectively. Over 7-18 months, within-group improvement in low density lipoprotein (LDL (-24±6 in RYGB, p=0.003, vs. -7±9mg/dL in SG, p=0.50 and non-high density lipoprotein (non-HDL cholesterol (-23±8 in RYGB, p=0.02, vs. -12±7 in SG, p=0.18 appeared to be of greater magnitude following RYGB. However, differences between groups did not reach statistical significance. When divided by non-alcoholic steatohepatitis stages (NASH, patients with Stage II-III NASH had greater reductions in ALT levels vs. those with Stage 0-I NASH (-45±18 vs -9±3, p=0.01 after 7-18 months. RYGB and SG groups did not differ for the magnitude of post-surgical changes in liver enzymes. Conclusion: RYGB and SG did not differ for the magnitude of BMI reduction across groups, though changes trended higher following RYGB. Further prospective studies are needed to confirm these findings.

  14. Bariatric surgery in old age: a comparative study of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in an Asia centre of excellence

    Institute of Scientific and Technical Information of China (English)

    Chih-Kun Huang; Amit Garg; Hsin-Chih Kuao; Po-Chih Chang; Ming-Che Hsin

    2015-01-01

    Bariatric surgery has been proved to be the safest and efficient procedure in treating morbid obese patients,but data is still lacking in the elderly population.The aim of our study was to compare the safety and efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (LSG) in patients aged more than 55 years.We performed a retrospective review of a prospectively collected database.All patients with body mass index (BMI) > 32 kg/m2 and aged more than 55 years undergoing LRYGB or LSG in BMI Surgery Centre,E-Da Hospital between January 2008 and December 2011 with at least one year of follow up were included for the analysis.Demography,peri-operative data,weight loss and surgical complications were all recorded and analyzed.Mean age and BMI of these 68 patients (22 males and 46 female) were 58.8 years (55-79 years) and 39.5 kg/m2 (32.00-60.40 kg/m2).LRYGB was performed in 44 patients and LSG in 24 patients.The two groups were comparable in their preoperative BMI,American Society of Anaesthesia (ASA) score and gender distribution.LSG patients were significantly older than patients receiving LRYGB.The proportion of type 2 diabetes preoperatively was significantly higher in LRYGB patients as compared to LSG patients (88.63% vs.50%; P < 0.01).The prevalence of other co-morbidities was similar and comparable between the groups.Mean BMI in the LRYGB and LSG groups at the end of 1 year were 28.8 kg/m2 and 28.2 kg/m2,respectively,and there was no statistically significant difference in mean percentage of excess weight loss (%EWL) at 1 year.The percentage of resolution of diabetes was significantly higher in LRYGB (69.2%) as compared to LSG (33.3%).On the other hand,there was no statistical difference in the percentage of resolution of hypertension,hyperlipidemia and fatty liver hepatitis.The overall morbidity and re-operation rate was higher in LRYGB patients.In morbidly elderly patients,both surgeries achieved good weight loss and

  15. Sleeve gastrectomy versus Roux-en-Y gastric bypass for type 2 diabetes and morbid obesity: double-blind randomised clinical trial protocol

    Science.gov (United States)

    Murphy, Rinki; Evennett, Nicholas J; Clarke, Michael G; Robinson, Steven J; Humphreys, Lee; Jones, Bronwen; Kim, David D; Cutfield, Richard; Plank, Lindsay D; Hammodat, Hisham; Booth, Michael W C

    2016-01-01

    Introduction Type 2 diabetes (T2D) in association with obesity is an increasing disease burden. Bariatric surgery is the only effective therapy for achieving remission of T2D among those with morbid obesity. It is unclear which of the two most commonly performed types of bariatric surgery, laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB), is most effective for obese patients with T2D. The primary objective of this study is to determine whether LSG or LRYGB is more effective in achieving HbA1c<6% (<42 mmol/mol) without the use of diabetes medication at 5 years. Methods and analysis Single-centre, double-blind (assessor and patient), parallel, randomised clinical trial (RCT) conducted in New Zealand, targeting 106 patients. Eligibility criteria include age 20–55 years, T2D of at least 6 months duration and body mass index 35–65 kg/m2 for at least 5 years. Randomisation 1:1 to LSG or LRYGB, used random number codes disclosed to the operating surgeon after induction of anaesthesia. A standard medication adjustment schedule will be used during postoperative metabolic assessments. Secondary outcomes include proportions achieving HbA1c<5.7% (39 mmol/mol) or HbA1c<6.5% (48 mmol/mol) without the use of diabetes medication, comparative weight loss, obesity-related comorbidity, operative complications, revision rate, mortality, quality of life, anxiety and depression scores. Exploratory outcomes include changes in satiety, gut hormone and gut microbiota to gain underlying mechanistic insights into T2D remission. Ethics and dissemination Ethics approval was obtained from the New Zealand regional ethics committee (NZ93405) who also provided independent safety monitoring of the trial. Study commenced in September 2011. Recruitment completed in October 2014. Data collection is ongoing. Results will be reported in manuscripts submitted to peer-reviewed journals and in presentations at national and international meetings

  16. Comparative study between laparoscopic gastric bypass and sleeve gastrectomy for simple obesity%腹腔镜胃旁路术与袖状胃切除术治疗单纯性肥胖症的对比研究

    Institute of Scientific and Technical Information of China (English)

    张光辉; 张进峰; 周宏建; 张春明

    2015-01-01

    目的探讨腹腔镜Roux-en-Y胃旁路术和腹腔镜袖状胃切除术治疗单纯性肥胖症的疗效差异。方法回顾性分析2010年8月至2012年12月在郑州市第二人民医院接受减肥手术治疗的单纯性肥胖患者的临床资料,其中接受腹腔镜胃旁路术28例,接受袖状胃切除术9例,临床检测指标包括术后6个月、12个月、24个月的BMI、空腹血糖水平(FPG)、血红蛋白(HGB)和微量元素(Ca2+、Fe2+、VitB12)。结果两组患者的手术时间存在明显差异(P<0.05),术后6个月、12个月、24个月的BMI、FPG、HGB和微量元素水平均未见明显差异。结论腹腔镜Roux-en-Y胃旁路术和袖状胃切除术均有确切的减肥疗效,疗效差异仍有待于更大样本更长时间的深入研究以发现。%Objective To explore the difference of efficacy between laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy for simple obesity.Methods Clinical data of simple obese patients undergoing bariatric surgeries in the Second Hospital of Zhengzhou from August 2010 to December 2012 were retrospectively studied, including laparoscopic Roux-en-Y gastric bypass group (n=28) and sleeve gastrectomy group (n=9). Clinical data included BMI、FPG、HGB、microelements (Ca2+、Fe2+、VitB12) at 6、12、24 months postoperatively.Results There was statistical difference in operation time (P<0.05), but the levels of BMI、FPG、HGB and microelements had no statistical differences at 6、12、24 months postoperatively between the two groups.Conclusions Laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy have a definite effect for simple obesity. Longer investigation duration and larger sample size are needed to verify the long-term differences between the two groups.

  17. Serum concentrations and subcutaneous adipose tissue mRNA expression of omentin in morbid obesity and type 2 diabetes mellitus: the effect of very-low-calorie diet, physical activity and laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Urbanová, M; Dostálová, I; Trachta, P; Drápalová, J; Kaválková, P; Haluzíková, D; Matoulek, M; Lacinová, Z; Mráz, M; Kasalický, M; Haluzík, M

    2014-01-01

    Omentin is a novel adipokine with insulin-sensitizing effects expressed predominantly in visceral fat. We investigated serum omentin levels and its mRNA expression in subcutaneous adipose tissue (SCAT) of 11 women with type 2 diabetes mellitus (T2DM), 37 obese non-diabetic women (OB) and 26 healthy lean women (C) before and after various weight loss interventions: 2-week very-low-calorie diet (VLCD), 3-month regular exercise and laparoscopic sleeve gastrectomy (LSG). At baseline, both T2DM and OB groups had decreased serum omentin concentrations compared with C group while omentin mRNA expression in SCAT did not significantly differ among the groups. Neither VLCD nor exercise significantly affected serum omentin concentrations and its mRNA expression in SCAT of OB or T2DM group. LSG significantly increased serum omentin levels in OB group. In contrast, omentin mRNA expression in SCAT was significantly reduced after LSG. Baseline fasting serum omentin levels in a combined group of the studied subjects (C, OB, T2DM) negatively correlated with BMI, CRP, insulin, LDL-cholesterol, triglycerides and leptin and were positively related to HDL-cholesterol. Reduced circulating omentin levels could play a role in the etiopathogenesis of obesity and T2DM. The increase in circulating omentin levels and the decrease in omentin mRNA expression in SCAT of obese women after LSG might contribute to surgery-induced metabolic improvements and sustained reduction of body weight.

  18. Exploration of standardized procedures of laparoscopic sleeve gastrectomy%腹腔镜胃袖状切除术的标准化操作流程探索

    Institute of Scientific and Technical Information of China (English)

    梁辉; 管蔚; 曹庆; 刘欢

    2015-01-01

    胃液漏、梗阻患者.第一阶段组、第二阶段组和第三阶段组患者手术时间分别为(91±31) min、(56±27) min、(54±18) min,术中出血量分别为(51±33) mL、(24±20) mL、(21±20)mL,术后住院时间分别为(4.1±3.4)d、(3.1±2.7)d、(3.0±2.1)d,术后1年EWL分别为67%±12%、65%±14%、68%±24%,3组患者在手术时间和术中出血量方面比较,差异均有统计学意义(F=7.471,6.037,P<0.05).3组患者术后住院时间、术后1年EWL方面比较,差异均无统计学意义(F=1.439,2.296,P>0.05).153例患者均获得术后随访.19例合并呼吸睡眠暂停综合征患者,术后3个月完全缓解.21例合并多囊卵巢综合征患者,术后均缓解.27例合并2型糖尿病患者,术后1年完全缓解25例,明显改善2例.79例合并脂代谢异常患者,术后1年脂代谢正常57例.112例脂肪肝患者,术后均有所改善.结论 腹腔镜胃袖状切除术安全、有效.手术操作可以标准化,切割线的全层缝合可能避免胃液漏的发生,术后可不放置胃管和腹腔引流管.%Objective To explore the standardized procedures of laparoscopic sleeve gastrectomy (LSG).Methods The clinical data of 153 patients with obesity who underwent LSG at the First Affiliated Hospital of Nanjing Medical University from December 2010 to December 2014 were retrospectively analyzed.All the 153 patients were divided into 3 groups:22 patients in the first stage group were admitted to the hospital from December 2010 to September 2011,57 patients in the second stage group were admitted to the hospital from October 2011 to December 2013 and 74 patients in the third stage group were admitted to the hospital from January 2014 to December 2014.In the first stage group,1.1 cm gastroscope in diameter was introduced into the pylorus as a support,great curve of stomach with 5 cm distances from the pylorus was cut using a green cartridge,and then blue cartridges were used at the body and fundus of stomach.The 3-0 vicryl continuous and

  19. 袖状胃切除术与Roux-en-Y胃转流术治疗肥胖及2型糖尿病疗效的Meta分析%A META-ANALYSIS OF SLEEVE GASTRECTOMY VERSUS ROUX-EN-Y GASTRIC BYPASS FOR MORBID OBESITY AND DIABETES MELLITUS

    Institute of Scientific and Technical Information of China (English)

    颜朝阳; 颜振民; 张志; 尉建安; 孙少华; 张忠涛; 孟化

    2016-01-01

    Objective:To review the effect of sleeve gastrectomy ( SG ) and Roux-en-Y gastric bypass( RYGB) for the treatment of obesity and type 2 diabetes. Methods:Electronic literature search was performed on PubMed,EMBASE,Cochrane Library,CNKI and Wanfang database from inception to October 1 ,2014 . The following medical subject headings ( MeSH ) and keywords were used:“bariatric surgery”、“T2 DM”、“gastric bypass”、“sleeve gastrectomy”、“RCT”. Finally we got 9 literatures focused on the comparison of the effect of sleeve gastrectomy and Roux-en-Y gastric bypass for the treatment of obesity and type 2 diabetes to review. Results:Among all the 9 included studies,a total of 713 cases were reported,including 315 patients in the sleeve gastrectomy group and 398 patients in the Roux-en-Y gastric bypass group. The results of the Meta analysis showed that there were no significant difference in the remission rate of T2DM(RR=0. 85,95%CI:0. 67 ~1. 09,P>0. 05),no significant difference in the percentage excess weight loss ( MD=0 . 29 , 95%CI:-6 . 51 ~7 . 10 , P>0 . 05 ) , no significant difference in the change of BMI(MD=-0. 32,95%CI:-1. 16~0. 51,P>0. 05). But in the incidence of complications,the sleeve gastrectomy showed significant advantage(RR=0. 55,95%CI:0. 33~0. 94,P0.05),术后多余体重降低百分比(MD=0.29,95%CI:-6.51~7.10,P>0.05)和术后体重指数(body mass index,BMI)变化(MD=-0.32,95%CI:-1.16~0.51,P>0.05)方面效果相当;在术后并发症方面,袖状胃切除术优于Roux-en-Y胃转流术(RR=0.55,95%CI:0.33~0.94,P<0.05)。结论:袖状胃切除术在对肥胖及2型糖尿病的治疗上可作为优选术式。

  20. 肥胖症患者袖状胃切除术的饮食护理与指导%Nutritional Care and Guidelines for Patients undergoing Laparoscopic Sleeve Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    潘莹莹; 谈锦艳; 侬宇琴; 陈雯; 李慧; 卓光鑽

    2014-01-01

    目的:探讨肥胖症患者袖状胃切除术的饮食护理及术后饮食指导,以保证患者围术期安全,提高手术疗效及患者术后生活质量。方法对2010年1月至2011年12月在第二军医大学长海医院微创外科实施腹腔镜下袖状胃切除术(laparo-scopic sleeve gastretomy,LSG)的82例肥胖症患者进行规范的围术期饮食护理及指导,术后定期进行营养跟踪教育。结果所有病例均顺利康复出院,并进行至少12个月的术后随访,体质量下降显著,相关并发症亦有不同程度改善。随访期内有15例患者出现脱发症状,其中1例较为严重,经饮食调整或药物治疗后均获不同程度缓解;所有病例均未见其他明显营养相关并发症。结论规范合理的饮食护理和指导是保证手术疗效、减少围术期并发症、避免术后营养相关并发症并提高患者生活质量的重要因素,值得临床推广应用。%Objective To discuss the measures of nutritional care and postoperative diet guidelines for the patients who undergo laparoscopic sleeve gastrectomy(LSG),and to ensure the safety in the perioperative period,getting the best operative efficacy and postoperative quality of life.Methods 82 patients underwent LSG surgery from department of minimally invasive surgery of Changhai Hospital during January 2010 to December 2011 were selected,normative nutritional care and guidelines were carried out,during the perioperative period,and a regular nutritional follow-up and tracking education were given after discharge. Results All the patients were fully recovered and discharged with 1 2 months of follow-up,with significant weight loss and less related complications.During this period,1 5 patients got hair loss,one of which was quite serious.All of them had been symptomatically improved in some degree respectively after dietary modification or medical treatment.All patients had no other significant nutritional-related complication. Conclusion

  1. Effects of Laparoscopic Sleeve Gastrectomy on Reproductive Endocrine Functions in Patients with Polycystic Ovary Syndrome%腹腔镜胃袖状切除对多囊卵巢综合征生殖内分泌功能改善的作用

    Institute of Scientific and Technical Information of China (English)

    王恺京; 忻颖; 周小钢; 徐冰; 支云清; 朱江帆

    2014-01-01

    Objective To explore the feasibility and clinical efficacy of laparoscopic sleeve gastrectomy for the improvement of reproductive endocrine functions in patients with polycystic ovary syndrome. Methods From February 2012 to February 2014, a total of 11 patients with polycystic ovarian syndrome underwent laparoscopic sleeve gastrectomy.The therapeutic effects of the operation like weight loss, menstrual cycle, and reproductive endocrine functions were followed up and observed. Results The laparoscopic sleeve gastrectomy was performed successfully in all the 11 patients.During postoperative follow-up, 10 (10/11) patients obtained normal menstruation in 3 months, and 6 (6/6) patients recovered from oligomenorrhea symptoms.At 3 months after surgery, 4 patients with hyperandrogenism preoperatively recovered to the normal levels.Four ( 4/7 ) patients with hirsute-syndrome were improved obviously after 3-6 months, with the Ferriman-Gallwey scores lower than 5.The BMI was decreased by 4.1-7.6 (5.3 ±1.5) during follow-up for 3 -24 months. Conclusion Laparoscopic sleeve gastrectomy can effectively improve clinical symptoms of obese patients with polycystic ovary syndrome, with fast recovery of menstrual cycle in a short time and significantly relieved hyperandrogenism.%目的:探讨腹腔镜胃袖状切除术改善多囊卵巢综合征( polycystic ovary syndrome,PCOS)生殖内分泌失调的可行性及临床疗效。方法2012年2月~2014年2月,对11例伴有肥胖的PCOS患者行腹腔镜胃袖状切除术,观察月经周期、生殖内分泌及体重等的变化。结果11例均成功完成腹腔镜胃袖状切除术,10例(10/11)术后3个月内月经恢复正常周期,其中6例(6/6)术前稀发排卵的患者均恢复正常排卵,4例术前高雄激素血症患者术后3个月雄激素水平均恢复到正常范围,4例(4/7)多毛患者术后3~6个月Ferriman-Gallwey多毛评分降至5分以下。术后随访3~24

  2. Efficacies of sleeve gastrectomy and Roux-en-Y gastric bypass for the treatment of type 2 diabetes mellitus: a Meta-analysis%胃袖状切除术与Roux-en-Y胃旁路术治疗2型糖尿病疗效的Meta分析

    Institute of Scientific and Technical Information of China (English)

    谢晓峰; 王琛; 李娜; 李倩; 张文亮; 李敏

    2013-01-01

    目的 系统评价胃袖状切除术与Roux-en-Y胃旁路术治疗2型糖尿病的疗效.方法 以减重手术、胃切除术、胃绕道术、胃旁路手术、胃转流术、胃袖状切除术、糖尿病、bariatric surgery、gastric bypass、sleeve gastrectomy、diabetes、T2DM等为关键词检索Cochrane library、PubMed、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库和万方数据库.检索时间为各数据库建库至2012年12月.最终纳入胃袖状切除术对比Roux-en-Y胃旁路术治疗2型糖尿病的相关文献,再由2名研究者分别独立提取数据并进行文献质量评价,用RevMan 5.1.2软件进行Meta分析.计数资料采用相对危险度(risk ratio,RR)或比值比(odds ratio,OR)分析统计,计量资料采用均数差(mean difference,MD)或标准差(standardmean difference,SMD)分析统计.采用I2对异质性进行定量分析.结果 共纳入符合标准的文献5篇,其中胃袖状切除术组164例,Roux-en-Y胃旁路术组184例.Meta分析结果显示:与胃袖状切除术比较,Roux-en-Y胃旁路术能更显著地提高患者糖尿病的缓解率(OR =0.48,95% CI:0.26 ~0.91,P<0.05),提高随访期间停止服药的比例(OR =0.37,95% CI:0.16 ~0.84,P <0.05),更有效降低糖化血红蛋白水平(MD=0.28,95%CI:0.14 ~0.43,P<0.05)和体质量(MD=-0.44,95% CI:-0.76 ~-0.13,P<0.05).胃袖状切除术与Roux-en-Y胃旁路术患者术后并发症发生率比较,差异无统计学意义(OR=1.81,95% CI:0.20~16.73,P>0.05).结论 Roux-en-Y胃旁路术较胃袖状切除术在治疗2型糖尿病的疗效方面具有一定的优势.%Objective To review the efficacies of sleeve gastrectomy and Roux-en-Y gastric bypass for the treatment of type 2 diabetes mellitus.Methods The Cochrane library,PubMed,China Journal Full Text Database,Chinese Scientific Journal Full Text Database,Chinese Biomedical Literature Database and Wanfang Database were searched with key

  3. Gastric lipoma excision during a laproscopic sleeve gastrecomy: A case report

    OpenAIRE

    Al Shammari, Jaber O.; Nimer Al-Shadidi; Ahmad J. Abdulsalam; Abdullah E. Al-Daihani

    2016-01-01

    Introduction: Gastric lipomas are rare benign mesenchymal tumors of the stomach. Case report: We report a 41 year old, morbid obese male, admitted for elective laparoscopic sleeve gastrectomy. Thorough preoperative assessment revealed a gastric lipoma in the antrum of the stomach measuring 3 × 3 cm. Due to the patient’s preference, surgical resection of the lipoma was done along with the laparoscopic sleeve gastrectomy procedure. Discussion: In our case, we report a rare case of submuco...

  4. Effect of sleeve gastrectomy plus side-to-side jejunoileal anastomosis on the expression of GLP-1 in ZDF rats%胃袖状切除附加空回肠吻合术对ZDF大鼠GLP-1蛋白表达的影响

    Institute of Scientific and Technical Information of China (English)

    周小钢; 王恺京; 徐安安; 高玮; 陆佳军; 朱江帆

    2015-01-01

    目的:探讨胃袖状切除加空回肠侧侧吻合术(sleeve gastrectomy plus side-to-side jejunoileal anastomosis,JI-SG)对糖尿病肥胖(Zucker diabetic fatty,ZDF)大鼠末端回肠黏膜组织胰高血糖素样肽-1(glucagon-like peptide 1,GLP-1)蛋白表达及空腹血糖的影响,探讨其降糖的可能机制.方法:将30只ZDF大鼠随机分为假手术(sham surgery,SS)组、胃袖状切除(sleeve gastrectomy,SG)组、JI-SG组,术后同等条件下饲养12用,观察血清血糖、GLP-1及胰岛素水平,于术后12周末检测GLP-1蛋白在回肠末端组织中的表达.结果:JI-SG组、SG组回肠末端GLP-1蛋白表达阳性率高于SS组(P<0.05),伴有L细胞增生;JI-SG组较SG组有显著性升高(P<0.05).SG组、JI-SG组血糖水平较SS组明显下降(P<0.05),同时JI-SG组较SG组降糖效果更加明显(P<0.05).SG组、JI-SG组血清胰岛素水平较SS组明显下降(P<0.05),同时JI-SG组低于SG组(P<0.05).SG组、JI-SG组血清GLP-1水平较SS组明显升高(P<0.05),同时JI-SG组高于SG组(P<0.05).结论:JI-SG可显著增强回肠末端GLP-1蛋白表达,同时伴有L细胞增生,可能是其具有显著且持续稳定降糖作用的原因.

  5. Gastric lipoma excision during a laproscopic sleeve gastrecomy: A case report

    OpenAIRE

    Al Shammari, Jaber O.; Al-Shadidi, Nimer; Ahmad J. Abdulsalam; Abdullah E. Al-Daihani

    2016-01-01

    Introduction Gastric lipomas are rare benign mesenchymal tumors of the stomach. Case report We report a 41 year old, morbid obese male, admitted for elective laparoscopic sleeve gastrectomy. Thorough preoperative assessment revealed a gastric lipoma in the antrum of the stomach measuring 3 × 3 cm. Due to the patient’s preference, surgical resection of the lipoma was done along with the laparoscopic sleeve gastrectomy procedure. Discussion In our case, we report a rare case of submucosal gastr...

  6. Effects of alveolar recruitment maneuver on perioperative pulmonary function in morbidly obese patients undergoing laparoscopic sleeve gastrectomy%肺复张对病态肥胖患者腹腔镜袖状胃切除术围术期肺功能的影响

    Institute of Scientific and Technical Information of China (English)

    魏珂; 曹俊; 彭丽桦; 黎平; 闵苏

    2016-01-01

    Objective To evaluate the effect of alveolar recruitment maneuver on the perioperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.Methods Forty morbidly obese patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-64 yr,with body mass index ≥ 40 kg/m2,scheduled for elective laparoscopic sleeve gastrectomy,were randomly divided into either control group (group C) or alveolar recruitment maneuver group (group R) using a random number table,with 20 patients in each group.Patients in group C were treated with volume-or pressure-controlled ventilation after creation of pneumoperitoneum,maintaining the peak inspiratory pressure (Ppeak) ≤ 30 cmH2O and partial pressure of end-tidal CO2 35-40 mmHg.Patients in group R received alveolar recruitment maneuver once every 30 min starting from creation of pneumoperitoneum until the end of surgery.Patients were transfered to post-anesthesia care unit (PACU) with endotracheal tube which was extubated when the unified extubation standard was achieved in PACU.The patients who stayed in PACU for 2 h showing no indications for extubation were transfered to intensive care unit for continuous ventilation support.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,and at the end of pneumoperitoneum,blood samples were collected from the radial artery for blood gas analysis.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak,plateau pressure (Peat),and dynamic lung compliance were recorded.The time for achieving extubation standard and time for achieving the standard for discharge from PACU were recorded.Patients were followed up until discharge,and the feeding time and duration of hospital stay were recorded.Results Compared with group C,PaO2 and

  7. Staple-line leak after sleve gastrectomy in obese patients:A hot topic in bariatric surgery

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Laparoscopic sleeve gastrectomy is a surgical procedurethat is being increasingly performed on obese patients.Among its complications, leaks are the most seriousand life threatening. The placement of esophageal,covered, self-expandable metal stents in these caseshas been performed by many authors but reports on theoutcome of this procedure are limited and the technicalaspects are not well defined. Stent migration is the maincomplication of the procedure and poses a challenge tothe surgeon, with a limited number of options. Here weevaluate the technical and clinical outcome of a new,dedicated, self-expanding metal stent, comparing theadvantages of this stent to those traditionally used totreat staple-line leak after sleeve gastrectomy. Whilepublished data are limited, they seem support the use ofthis kind of new stent as the best option for the stentingtreatment of a staple-line leak after sleeve gastrectomy,over other kinds of stents. Further studies based onlarger series are needed to better evaluate patientoutcome.

  8. Wernicke’s encephalopathy after sleeve gastrectomy: Literature review

    Directory of Open Access Journals (Sweden)

    Fernando Pardo-Aranda

    2016-01-01

    Conclusion: Nutritional deficiencies after restrictive procedures are uncommon but easily preventable and can result in life threatening. With the upswing of bariatric surgery, surgeons and emergency physicians should be able to diagnose and treat those complications. Prophylactic thiamine should be administered to patients with predisposing factors.

  9. 腹腔镜管状胃胃切除术治疗肥胖症合并2型糖尿病患者的围手术期护理%Perioperative nursing of laparoscopic sleeve gastrectomy for obesity patients with type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    刘蕾; 杨筱萃; 李慧; 潘莹莹; 卓光鑽; 谈锦艳

    2012-01-01

    目的:探讨腹腔镜下管状胃胃切除术(LSG)治疗肥胖症合并2型糖尿病(diabetes mellitus,2型DM)患者的围手术期护理措施,以提高护理质量.方法:选择19例行LSG肥胖症合并2型DM患者,术前加强心理疏导,讲解肥胖及2型DM危害,科普手术知识及风险-效益比;术后加强导管护理及并发症观察,注意饮食和运动指导,强调严格遵食谱饮食及定期随访的重要性.总结LSG治疗肥胖症合并2型DM的围术期护理流程.结果:本组19例患者手术均经腹腔镜完成,无中转开腹,术后均顺利康复出院,围手术期无手术及护理并发症发生.结论:有效的围手术期护理措施是保障手术成功的重要因素,应针对肥胖症合并2型DM患者的疾病及心理特点,采取有针对性的护理措施,促进患者早日康复,提高患者的生存质量.%Objective:To investigate the effective perioperative nursing measures of laparoscopic sleeve gastrectomy (LSG) for type 2 diabetes mellitus. Methods; 19 patients with obesity combined with type 2 diabetes mellitus were included. Before LSG procedure,all the patients underwent the psychothera-py, got a better understanding of the dangers of obesity and type 2 diabetes mellitus and informed of the procedure and cost - effectiveness. After the proce-dure, catheter care was performed and complications were closed observed. Patients were guided to undertake some exercise and watch their diet. All patients were aware of the importance of sticking to rigid diet and regularly follow - up. On that basis, the procedures of perioperative nursing for obesity combined with type 2 diabetes mellitus were concluded. Results:All cases were successfully operated by laparoscope. There was no conversion. All the patients recov-ered uneventful and were discharged. No procedure or nursing - related complication was seen during the perioperative period. Conclusion:The effective perioperative nursing was a most important factor for a

  10. Establishment and analysis of the rat model of sleeve gastrectomy plus side-to-side jejunoileal anastomosis in ZDF rats%ZDF大鼠胃袖状切除附加空回肠侧侧吻合术动物模型的建立

    Institute of Scientific and Technical Information of China (English)

    王恺京; 徐安安; 朱江帆; 周小钢; 高玮; 陆佳军; 刘晓慧; 陈志国; 殷晓琦

    2015-01-01

    目的:为2型糖尿病治疗机制方面的研究提供稳定、持久的降糖手术模型,用肥胖糖尿病(Zucker diabetic fatty,ZDF)大鼠建立胃袖状切除加空回肠侧侧吻合术(sleeve gastrectomy plus side-to-side jejunoileal anastomosis,JI-SG)动物模型.方法:将30只7周龄雄性ZDF大鼠随机分为3组,每组10只,分别为JI-SG组、假手术(sham operation,SO)组(SO组)、饮食控制组(对照组).观察并测量各组大鼠术前1d及术后1、3、6周体质量、空腹血糖.结果:手术大鼠存活率为90%(27/30),JI-SG组1只大鼠于术后第1天死亡,2只大鼠于术后3周后死亡.3组大鼠术前体质量、空腹血糖差异无统计学意义.对照组经饮食控制1周后体重上升缓慢,恢复正常饮食后体重迅速上升.JI-SG组及SO组术后大鼠体质量均进行性下降.SO组术后第7天体质量降至最低体重,此后明显上升;JI-SG组术后体重持续下降,术后6周,JI-SG大鼠体重明显小于其他两组,差异有统计学意义(P<0.05).术后对照组血糖稳步上升,SO组血糖下降后迅速上升,JI-SG组大鼠血糖逐渐下降至正常水平,术后6周3组间血糖差异有统计学意义(P<0.05).结论:本研究成功建立了ZDF大鼠JI-SG手术模型,此术式明显降低了ZDF大鼠体重、改善了ZDF血糖代谢,为2型糖尿病治疗机制的研究提供了一种稳定、持久的降糖手术模型.

  11. Aspectos técnicos da interposição ileal com gastrectomia vertical como possível opção ao tratamento do diabetes mellitus tipo 2 Technical aspects of ileal interposition with sleeve gastrectomy as a possible option for the treatment of type 2

    Directory of Open Access Journals (Sweden)

    Aureo Ludovico de Paula

    2010-06-01

    mortalidade, factível cirurgicamente pela via laparoscópica e passível de ser ofertada como opção operatória ao tratamento da diabetes mellitus tipo 2.INTRODUCTION: There is an evidence that the best results in terms of resolution of diabetes in morbidly obese patients are achieved with bilio-pancreatic bypass, especially the duodenal switch. These operations are characterized by partial gastrectomy and the rapid transit of food into the distal ileum through derivation of a significant segment of small intestine. The idea of performing the technique presented here was based on these principles. METHOD: The procedures are usually performed laparoscopically, after establishment of a pneumoperitoneum at 12-15 mmHg and introduction of six trocars. The patient is initially positioned in 30° reverse Trendelenburg with the surgeon on the right side of the patient. The sleeve gastrectomy is performed using the anatomical distal trifurcation of the anterior vagus nerve as a reference. The devascularization of the greater curvature is performed and extends to the oesophagogastric junction. With an intra-gastric calibration tube of 20 mm positioned along the lesser curvature, gastric resection starts at the proximal antrum with linear stapler up to oesophagogastric angle. An invaginating running suture is also performed. To perform the ileal interposition in the proximal jejunum, it is divided 20-30 cm distally with a 45-mm linear stapler. The cecum is identified and the distal ileum transected 30cm proximal to the ileocecal valve. A 170 to 200 cm of ileum was measured proximally along the anti-mesenteric border using a 10-cm marked atraumatic grasper, and transected with a 45-mm linear stapler. This segment of ileum is interposed in an isoperistaltic way into the proximal jejunum, previously divided. Next are perform three side-to-side enteroanastomosis. The first enteroanastomosis is the ileo-ileostomy, then the jejuno-ileostomy and finally, the ileo-jejunostomy. All three

  12. ENDOSCOPIC SLEEVE GASTROPLASTY - MINIMALLY INVASIVE THERAPY FOR PRIMARY OBESITY TREATMENT

    Science.gov (United States)

    GALVÃO-NETO, Manoel dos Passos; GRECCO, Eduardo; de SOUZA, Thiago Ferreira; de QUADROS, Luiz Gustavo; SILVA, Lyz Bezerra; CAMPOS, Josemberg Marins

    2016-01-01

    ABSTRACT Background: Less invasive and complex procedures have been developed to treat obesity. The successful use of Endoscopic Sleeve Gastroplasty using OverStitch(r) (Apollo Endosurgery, Austin, Texas, USA) has been reported in the literature. Aim: Present technical details of the procedure and its surgical/ endoscopic preliminary outcome. Method: The device was used to perform plications along the greater curvature of the stomach, creating a tubulization similar to a sleeve gastrectomy. Result: A male patient with a BMI of 35.17 kg/m2 underwent the procedure, with successful achievement of four plications, and preservation of gastric fundus. The procedure was successfully performed in 50 minutes, time without bleeding or other complications. The patient presented mild abdominal pain and good acceptance of liquid diet. Conclusions: The endoscopic gastroplasty procedure was safe, with acceptable technical viability, short in duration and without early complications. PMID:27683786

  13. Sleeve puller salvages welded tubes

    Science.gov (United States)

    Weaver, J. F.

    1980-01-01

    Tool removes sleeve remnants without distorting or damaging tubes, unlike pliers and other conventional handtools. Tubes can be reused, saving time, labor, and material in many applications. Sleeve-removal fixture consists of pressure screw, swing arm, locking screws, and base. It removes sleeve remnant from tubing after welded joint has been sawed through.

  14. Bursectomy at radical gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Cuneyt; Kayaalp

    2015-01-01

    Radical gastrectomy with extended lymph node dissec tion and prophylactic resection of the omentum, peri toneum over the posterior lesser sac, pancreas and/o spleen was advocated at the beginning of the 1960 s in Japan. In time, prophylactic routine resections of the pancreas and/or spleen were abandoned because of the high incidence of postoperative complications. However omentectomy and bursectomy continued to be standard parts of traditional radical gastrectomy. The bursaomentalis was thought to be a natural barrier against invasion of cancer cells into the posterior part of the stomach. The theoretical rationale for bursectomy was to reduce the risk of peritoneal recurrences by eliminating the peritoneum over the lesser sac, which might include free cancer cells or micrometastases. Over time, the indication for bursectomy was gradually reduced to only patients with posterior gastric wall tumors penetrating the serosa. Despite its theoretical advantages, its benefit for recurrence or survival has not been proven yet. The possible reasons for this inconsistency are discussed in this review. In conclusion, the value of bursectomy in the treatment of gastric cancer is still under debate and large-scale randomized studies are necessary. Until clear evidence of patient benefit is obtained, its routine use cannot be recommended.

  15. 胃袖状切除联合空回肠侧侧吻合术对2型糖尿病大鼠减重与改善代谢的影响%Effects of sleeve gastrectomy plus side-to-side jejunoileal anastomosis on weight loss and metabolic control of the rats with type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    王恺京; 徐安安; 周小钢; 陆佳军; 高玮; 陈志国; 刘晓慧; 朱江帆

    2015-01-01

    Objective To investigate the effects of sleeve gastrectomy (SG) plus side-to-side jejunoileal anastomosis on weight loss and metabolic control in a rat model of type 2 diabetes mellitus.Methods Thirty male Zucker diabetic fatty (ZDF) rats aged 7 weeks were divided into the JI-SG group,the SG group and the control group based on the random number table.Ten rats in the JI-SG group received SG plus side-to-side jejunoileal anastomosis,10 rats in the SG group receive SG and 10 rats in the control group received sham surgery.Body weight and fasting blood glucose were detected at preoperative day 1 and at preoperative week 1,2,4,6,8,10,12.Fasting plasma insulin,ghrelin and glucagon-like peptide 1 (GLP-1) were detected at preoperative day 1 and postoperative week 6 and 12.The measurement data with normal distribution were presented as x ± s.The comparison between groups was analyzed using the LSD-t test and comparisons among many groups were done using ANOVA.The repeated measurement data were analyzed by the repeated measures ANOVA.Results The body weight of rats in the JI-SG,SG and control group were changed from (297.2 ± 2.1) g,(302.0 ± 1.8) g and (296.0 ± 2.1) g before operation to (242.7 ± 13.2) g,(380.4 ± 16.5) g and (440.1 ± 15.1) g at postoperative week 12,there was an upward trend between the control group and the SG group and a steady trend in the JI-SG group,with a significant difference among the 3 groups (F =42.5,P < 0.05).The levels of blood glucose in JI-SG,SG and control group before operation were (11.7 ± 1.7) mmol/L,(11.4 ± 3.1) mmol/L and (12.4 ± 1.5) mmol/L,with no significant difference among the 3 groups (F =18.2,P > 0.05).The levels of blood glucose in JI-SG group,the SG group and the control group were changed from (5.7 ± 0.7) mmol/L,(6.2 ± 1.6) mmol/L and (7.4 ±0.5) mmol/L at postoperative week 1 to (6.9 ± 2.5) mmol/L,(13.9 ± 2.8) mmol/L and (22.2 ± 2.9) mmol/L at postoperative week 12,showing a slow upward trend between the JI

  16. Intrathoracic Hernia after Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Yoshihiko Tashiro

    2016-05-01

    Full Text Available Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation.

  17. Intrathoracic Hernia after Total Gastrectomy.

    Science.gov (United States)

    Tashiro, Yoshihiko; Murakami, Masahiko; Otsuka, Koji; Saito, Kazuhiko; Saito, Akira; Motegi, Kentaro; Date, Hiromi; Yamashita, Takeshi; Ariyoshi, Tomotake; Goto, Satoru; Yamazaki, Kimiyasu; Fujimori, Akira; Watanabe, Makoto; Aoki, Takeshi

    2016-01-01

    Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation. PMID:27403095

  18. Post-gastrectomy spleen enlargement and esophageal varices: Distal vs total gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Takatsugu; Oida; Kenji; Mimatsu; Hisao; Kano; Atsushi; Kawasaki; Youichi; Kuboi; Nobutada; Fukino; Sadao; Amano

    2010-01-01

    AIM: To study the relationship between platelet count-to-spleen diameter ratio and post-gastrectomy esopha-geal varices (EVs) development in patients without liver cirrhosis or hepatitis. METHODS: We retrospectively studied 92 patients who underwent gastrectomy. They were divided into 2 groups on the basis of the surgical treatment: the distal gastrectomy (DG) group and total gastrectomy (TG) group. The incidence of EVs was determined and postoperative platelet counts, spleen diameters, and platelet count-t...

  19. Sleeving repair of heat exchanger tubes

    International Nuclear Information System (INIS)

    Defective heat exchanger tubes can be repaired using techniques that do not involve the cost and schedule penalties of component replacement. FTI's years of experience repairing steam generator tubes have been successfully applied to heat exchangers. Framatome Technologies heat exchanger sleeves can bridge defective areas of the heat exchanger tubes, sleeves have been designed to repair typical heat exchanger tube defects caused by excessive tube vibration, stress corrosion cracking, pitting or erosion. By installing a sleeve, the majority of the tube's heat transfer and flow capacity is maintained and the need to replace the heat exchanger can be delayed or eliminated. Both performance and reliability are improved. FTI typically installs heat exchanger tube sleeves using either a roll expansion or hydraulic expansion process. While roll expansion of a sleeve can be accomplished very quickly, hydraulic expansion allows sleeves to be installed deep within a tube where a roll expander cannot reach. Benefits of FTI's heat exchanger tube sleeving techniques include: - Sleeves can be positioned any where along the tube length, and for precise positioning of the sleeve eddy current techniques can be employed. - Varying sleeve lengths can be used. - Both the roll and hydraulic expansion processes are rapid and both produce joints that do not require stress relief. - Because of low leak rates and speed of installations, sleeves can be used to preventatively repair likely-to-fail tubes. - Sleeves can be used for tube stiffening and to limit leakage through tube defects. - Because of installation speed, there is minimal impact on outage schedules and budgets. FTI's recently installed heat exchanger sleeving at the Kori-3 Nuclear Power Station in conjunction with Korea Plant Service and Engineering Co., Ltd. The sleeves were installed in the 3A and 3B component cooling water heat exchangers. A total of 859 tubesheet and 68 freespan sleeves were installed in the 3A heat

  20. Wakes of idealized propeller shafts with sleeves

    Energy Technology Data Exchange (ETDEWEB)

    Hally, D. [Defence R and D Canada - Atlantic, Dartmouth, Nova Scotia (Canada)]. E-mail: david.hally@drdc-rddc.gc.ca

    2005-07-01

    The rotation of a bare propeller shaft on a twin screw ship can have a significant effect on the flow into the propeller plane, with consequent effects on the propeller efficiency and cavitation characteristics. TRANSOM, the DRDC Atlantic flow solver, was used to determine whether covering the shaft with a nonrotating sleeve along part of its length would improve the propeller inflow. Two sets of calculations were performed. In the first a semi-infinite cylindrical shaft protruded from a flat plate. The shaft was covered along part of its length by a zero thickness stationary sleeve. To gain an understanding of the effects of the diameter of the sleeve relative to the shaft, a second set of calculations was performed in which the diameter of the sleeve was larger than that of the shaft. To avoid complications in gridding this configuration, the flat plate was removed; the shaft was infinite in both directions with a change in radius and a change from non-rotating to rotating in the middle. These calculations suggest that a sleeve will reduce the wake fraction in the propeller disk by delaying the formation of a vortex that entrains velocity deficit from the hull boundary layer. The sleeve also keeps the entrained velocity deficit closer to the shaft where it is less likely to induce cavitation. As the mismatch in radii of the sleeve and shaft increases, the entrained velocity deficit increases, so thinner sleeves should be preferred. (author)

  1. Single port Billroth I gastrectomy

    Directory of Open Access Journals (Sweden)

    Jeremy R Huddy

    2013-01-01

    Full Text Available Introduction: Experience has allowed increasingly complex procedures to be undertaken by single port surgery. We describe a technique for single port Billroth I gastrectomy with a hand-sewn intracorporeal anastomosis in the resection of a benign tumour diagnosed incidentally on a background of cholelithiasis. Materials and Methods: Single port Billroth I gastrectomy and cholecystectomy was performed using a transumbilical quadport. Flexible tipped camera and straight conventional instruments were used throughout the procedure. The stomach was mobilised including a limited lymph node dissection and resection margins in the proximal antrum and duodenum were divided with a flexible tipped laparoscopic stapler. The lesser curve was reconstructed and an intracorporal hand sewn two layer end-to-end anastomosis was performed using unidirectional barbed sutures. Intraoperative endoscopy confirmed the anastomosis to be patent without leak. Results: Enteral feed was started on the day of surgery, increasing to a full diet by day 6. Analgesic requirements were a patient-controlled analgesia morphine pump for 4 postoperative days and paracetamol for 6 days. There were no postoperative complications and the patient was discharged on the eighth day. Histology confirmed gastric submucosal lipoma. Discussion: As technology improves more complex procedures are possible by single port laparoscopic surgery. In this case, flexible tipped cameras and unidirectional barbed sutures have facilitated an intracorporal hand-sewn two layer end-to-end anastomosis. Experience will allow such techniques to become mainstream.

  2. Root cause analysis of thermal sleeve separation

    Energy Technology Data Exchange (ETDEWEB)

    Jo, J. C.; Jhung, M. J.; Yu, S. O.; Kim, H. J.; Yune, Y. K.; Park, J. Y

    2006-01-15

    Thermal sleeves in the shape of thin wall cylinder seated inside the nozzle part of each Safety Injection (SI) line at Pressurized Water Reactors (PWRs) have such functions as prevention and relief of potential excessive transient thermal stress in the wall of SI line nozzle part which is initially heated up with hot water flowing in the primary coolant piping system when cold water is injected into the system through the SI nozzles during the SI operation mode. Recently, mechanical failures that the sleeves were separated from the SI branch pipe and fell into the connected cold leg main pipe occurred in sequence at some typical PWR plants in Korea. To find out the root cause of thermal sleeve breakaway failures, the flow situation in the junction of primary coolant main pipe and SI branch pipe, and the vibration modal characteristics of the thermal sleeve are investigated in detail by using both Computational Fluid Dynamic (CFD) code and structure analysis finite element code. As the results, the transient response in fluid force exerting on the local part of thermal sleeve wall surface to the primary coolant flow through the pipe junction area during the normal reactor operation mode shows oscillatory characteristics with frequencies ranging from 17 to 18, which coincide with one of the lower mode natural frequencies of thermal sleeve having a pinned support condition on the circumferential prominence on the outer surface of thermal sleeve which is put into the circumferential groove on the inner surface of SI nozzle at the mid-height of the thermal sleeve. In addition, the variation of force on the thermal sleeve surface yields alternating torques in the directions of two rectangular axes which are perpendicular to the longitudinal axis of cylindrical thermal sleeve, which cause rolling, pitching and rotating motions of the thermal sleeve. Consequently, it is seen that this flow situation surrounding the thermal sleeve during the normal reactor operation can

  3. 舰载宽带单极套筒天线的FDTD建模及设计方法研究%FDTD Modeling and Design of Shipboard Broad Band Monopole Sleeve Antenna

    Institute of Scientific and Technical Information of China (English)

    李戈阳; 高火涛; 王剑波

    2011-01-01

    为了实现舰载天线的可视化分析与设计,采用时域有限差分法(FDTD)建立了细同轴天线的电磁模型,并基于此模型设计了100~400MHz舰载单极套筒天线。通过仿真计算研究了天线几何参数对天线电性能的影响,仿真结果表明该天线具有宽频带特性,但驻波比在高频段不够理想,因此进一步对天线顶端进行了阻抗加载。研究表明,在天线增益不高的前提下该加载方法有效地将驻波比控制在2.5以下。文中所采用的天线建模、设计、仿真以及电抗加载方法,对舰载天线的优化设计与电磁兼容分析均有一定的参考意义。%To carry out visual analysis and design of shipboard antenna, the mathematic and physical model of thin sleeve monopole antenna was established based on Finite Difference Time Domain (FDTD) method. By this model, a shipboard monopole sleeve antenna working at 100 MHz-400 MHz was designed. The effects of geometrical parameters on the electrical property of antenna were analyzed numerically. The simulation results showed that the antenna was kind of broadband, but the Voltage Standing Wave Ratio(VSWR) was not good enough in high frequency range, and impedance loading technique for the top antenna was introduced. The simulation results demonstrate that the broadband is constrained below 2.5 without gain reduction of antenna. The modeling, design, simulation and impedance loading technique employed in the paper are beneficial to the optimum design and EMC analysis of shipboard antennas.

  4. Steam generator tube laser sleeving

    International Nuclear Information System (INIS)

    For many years, Framatome has been used with different techniques and means to perform the steam generator tube sleeving operation, such as the 'mechanical' either GTAW welded or kinetic welding process. As soon as first power laser units appeared on the market we felt right interested in applying this process to the sleeving operation. After comparison between all the processes and equipments existing at that time (that is to say CO2 and YAG laser units), we chose the YAG and bought a 1.2 kW NEC laser unit in 1988. As it was installed in our Welding Center of Le Creusot, this equipment enabled us carrying out a preliminary test programme which targets were: getting the mastery of the equipment and associated technologies, implementing this process for the sleeve welding operation by improvement of the welding-pen. The NEC laser unit became afterwards transferred to our workshop in Chalon-sur-Saone (June 1990), where we achieved the final tests of the process at the same time we were investigating the development of industrial operation means. The actual program is mainly focused on 7/8'' tube steam generator repair process at tubesheet outlet. Yet made sure that our methods and means apply as well to 3/4'' tubes up to second tube support-plate level. Sleeves are made of heat-treated Inconel 690. The sleeved unit has been designed to provide the same breaking strength and leak-tightness as the tube. The upper part of sleeve consists of an anti-pop out length which ensures some locking-up in case the tube breaks in upper transition expansion area. Preliminary tests dealt with the various parameters which may exert an influence on geometry and quality of the, weld bead, as: - laser beam power (for continuous and pulsed modes), - welding speed, - focal spot size and location from the surface to be welded, - protective gas. After performance of preliminary tests on many thousands of weld beads we decided to use the process according to following criteria: Weld quality

  5. Liver transplantation and sleeve gastrectomy in the medically complicated obese: New challenges on the horizon

    Institute of Scientific and Technical Information of China (English)

    Diego; C; Reino; Keri; E; Weigle; Erik; P; Dutson; Adam; S; Bodzin; Keri; E; Lunsford; Ronald; W; Busuttil

    2015-01-01

    In the last 30 years, operative, technical and medical advances have made liver transplantation(LT) a lifesaving therapy that is used worldwide today. Global industrialization has been a contributor to morbid obesity and this has brought about the metabolic syndrome along with many downstream complications of such. Non-alcoholic steatohepatitis(NASH) has become a recognized hepatic manifestation of the metabolic syndrome and NASH cirrhosis is predicted to be the primary indication for LT in the United States by 2025. Several case series and database reviews have begun analyzing the efficacy of weight reduction surgery in the LT recipient. These data have reasonably demonstrated that weight reduction surgery in the LT recipient is a feasible endeavor. However, several questions have been raised regarding the type of weight reduction surgery, timing of surgery in relation to LT, patient and allograft survival and post-LT maintenance of weight loss to name a few. We look forward to a time when weight reduction surgery will work to improve the technical conduct of LT, improve perioperative benchmarks such as blood transfusions, intensive care unit length of stay and help to prevent recurrence of NASH cirrhosis in the medically complicated obese patient. In the meantime, well-designed prospective clinical trials that focus on the issues highlighted will help guide us in the care of these complicated patients who will soon account for the majority of the patients in our clinics.

  6. Totally Laparoscopic Gastrectomy for Gastric Cancer

    OpenAIRE

    Theodorous, Arianne N.; Train, William W.; Goldfarb, Michael A.; Borao, Frank J.

    2013-01-01

    Background and Objectives: Recent studies have supported minimally invasive techniques as a viable alternative to open surgery in the treatment of gastric cancer. The goal of this study is to review our institution's experience with totally laparoscopic gastrectomy for the treatment of both early- and advanced-stage gastric cancer. Methods: A retrospective study was conducted to examine the short-term outcomes of laparoscopic gastrectomy performed at Monmouth Medical Center between May 2003 a...

  7. Robotic versus Laparoscopic versus Open Gastrectomy: A Meta-Analysis

    Science.gov (United States)

    Marano, Alessandra; Choi, Yoon Young; Kim, Yoo Min; Kim, Jieun; Noh, Sung Hoon

    2013-01-01

    Purpose To define the role of robotic gastrectomy for the treatment of gastric cancer, the present systematic review with meta-analysis was performed. Materials and Methods A comprehensive search up to July 2012 was conducted on PubMed, EMBASE, and the Cochrane Library. All eligible studies comparing robotic gastrectomy versus laparoscopic gastrectomy or open gastrectomy were included. Results Included in our meta-analysis were seven studies of 1,967 patients that compared robotic (n=404) with open (n=718) or laparoscopic (n=845) gastrectomy. In the complete analysis, a shorter hospital stay was noted with robotic gastrectomy than with open gastrectomy (weighted mean difference: -2.92, 95% confidence interval: -4.94 to -0.89, P=0.005). Additionally, there was a significant reduction in intraoperative blood loss with robotic gastrectomy compared with laparoscopic gastrectomy (weighted mean difference: -35.53, 95% confidence interval: -66.98 to -4.09, P=0.03). These advantages were at the price of a significantly prolonged operative time for both robotic gastrectomy versus laparoscopic gastrectomy (weighted mean difference: 63.70, 95% confidence interval: 44.22 to 83.17, P<0.00001) and robotic gastrectomy versus open gastrectomy (weighted mean difference: 95.83, 95% confidence interval: 54.48 to 137.18, P<0.00001). Analysis of the number of lymph nodes retrieved and overall complication rates revealed that these outcomes did not differ significantly between the groups. Conclusions Robotic gastrectomy for gastric cancer reduces intraoperative blood loss and the postoperative hospital length of stay compared with laparoscopic gastrectomy and open gastrectomy at a cost of a longer operating time. Robotic gastrectomy also provides an oncologically adequate lymphadenectomy. Additional high-quality prospective studies are recommended to better evaluate both short and long-term outcomes. PMID:24156033

  8. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available Weighing the Options: Gastric Sleeve Surgery Halifax Health Florida December 7, 2011 I chose to have bariatric surgery because I have struggled with yo-yo dieting for probably 25 years, and ...

  9. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available ... that using this gastric sleeve, and the stapling gun that we are going to demonstrate here in ... stapler, right here. Alright, and that’s the staple gun you’ve got around the stomach right now. ...

  10. Myocardial Sleeve Tissues in Surgical Lung Specimens.

    Science.gov (United States)

    Yoshida, Akihiko; Kamata, Tsugumasa; Iwasa, Takeshi; Watanabe, Shun-ichi; Tsuta, Koji

    2015-10-01

    Left atrial myocardial extensions over the pulmonary veins (PVs), known as myocardial sleeves, are present in the physiological anatomy of most individuals. Although this structure has recently received clinical attention as a major origin of paroxysmal atrial fibrillation (AF), it has not been documented in surgical specimens. Here, we examine incidentally identified myocardial sleeve tissue in routinely processed lung resection specimens to determine its incidence and diagnostic implications. Among 694 lung resection specimens with evaluable PV margins, myocardial sleeve tissue was identified in 26 cases (3.7%). The tissue was located within the adventitia of the PVs, mostly in margin preparations, and existed outside the pericardium in the majority of cases. Carcinoma infiltration of the sleeves was evident in 6 cases. No heart injuries were observed, and no tumors invaded the heart. Preoperative electrocardiography showed sinus rhythm in all cases, whereas postoperative monitoring revealed sinus rhythm in all patients except one who showed AF and flutter. Myocardial sleeve tissue is an underrecognized incidental finding in lung resection specimens, and it is not indicative of heart injury. Cancer infiltration into this tissue indicates neither heart invasion nor, by itself, invasion into the pericardium. Although surgical transection of the myocardial sleeve did not evoke immediate arrhythmia in most cases, the overall influence of this procedure on the postsurgical risk of AF remains to be determined in further studies involving extensive rhythm assessment. PMID:26099012

  11. Sleeve Muscle Actuator: Concept and Prototype Demonstration

    Institute of Scientific and Technical Information of China (English)

    Tad Driver; Xiangrong Shen

    2013-01-01

    This paper presents the concept and prototype demonstration results of a new sleeve muscle actuator,which provides a significantly improved performance through a fundamental structural change to the traditional pneumatic muscle.Specifically,the sleeve muscle incorporates a cylindrical insert to the center of the pneumatic muscle,and thus eliminates the central portion of the intemal volume.Through the analysis of the actuation mechanism,it is shown that the sleeve muscle is able to provide a consistent increase of force capacity over the entire range of motion.Furthermore,the sleeve muscle provides a significant energy saving effect,as a result of the reduced internal volume as well as the enhance force capacity.To demonstrate this new concept,a sleeve muscle prototype was designed and fabricated.Experiments conducted on the prototype verified the improvement in the force capacity and demonstrated a significant energy saving effect (20%-37%).Finally,as the future work on this new concept,the paper presents a new robotic elbow design actuated with the proposed sleeve muscle.This unique design is expected to provide a highly compact and powerful actuation approach for robotic systems.

  12. Negative pressures during swing phase in below-knee prostheses with rubber sleeve suspension.

    Science.gov (United States)

    Chino, N; Pearson, J R; Cockrell, J L; Mikishko, H A; Koepke, G H

    1975-01-01

    Negative pressures in the small space between the distal stump and the below-knee prosthetic socket were measured during swing phase for a series of nine subjects. A molded rubber sleeve connecting the prosthesis and the thigh was found to enhance this effect so that suction suspension occurred during the entire swing phase. Deterioration of the suction occurred when the sleeve was intentionally pierced, and when other suspensions such as a suprapatellar cuff or thigh band were tested. The findings indicate that the total-contact socket, gel liner and elastic sleeve combine to create suction in the below-knee socket which improves overall comfort and function for the patient in using the prosthesis.

  13. Downhole tool with replaceable tool sleeve sections

    Energy Technology Data Exchange (ETDEWEB)

    Case, W. A.

    1985-10-29

    A downhole tool for insertion in a drill stem includes elongated cylindrical half sleeve tool sections adapted to be non-rotatably supported on an elongated cylindrical body. The tool sections are mountable on and removable from the body without disconnecting either end of the tool from a drill stem. The half sleeve tool sections are provided with tapered axially extending flanges on their opposite ends which fit in corresponding tapered recesses formed on the tool body and the tool sections are retained on the body by a locknut threadedly engaged with the body and engageable with an axially movable retaining collar. The tool sections may be drivably engaged with axial keys formed on the body or the tool sections may be formed with flat surfaces on the sleeve inner sides cooperable with complementary flat surfaces formed on a reduced diameter portion of the body around which the tool sections are mounted.

  14. Prevalence of Non-Alcoholic Fatty Liver Disease in Morbidly Obese Patients Undergoing Sleeve Bariatric Surgery in Iran and Association With Other Comorbid Conditions

    Directory of Open Access Journals (Sweden)

    Karimi-Sari

    2015-04-01

    Full Text Available Background Nonalcoholic fatty liver disease (NAFLD is one of the most common causes of chronic liver disease including simple steatosis to nonalcoholic steatohepatitis (NASH. NASH could progress to cirrhosis and liver cancer. The prevalence of NAFLD is increasing by increasing the prevalence of obesity. Objectives This study was designed to determine the prevalence of NASH in morbidly obese patients undergoing sleeve bariatric surgery and its correlation with other comorbidities. Patients and Methods In this analytical cross-sectional study, 114 morbidly obese patients undergoing sleeve gastrectomy were selected. Liver ultrasonography was performed for all patients before surgery and NAFLD existence and its grade was determined by hyperechoic texture and fatty infiltration. The liver enzymes and lipid profile were also measured. Prevalence of NAFLD in these patients and its correlation with other comorbid conditions (e.g. diabetes mellitus, hyperlipidemia, hypertension, hypothyroidism and ischemic heart disease were evaluated by SPSS software version 18. Results One hundred fourteen patients with a mean age of 33.96 ± 9.92 years and mean BMI of 43.61 ± 5.77 kg/m2 were enrolled (48 males and 66 females. The prevalence of NAFLD was 16.7%. NAFLD existence was associated with systolic blood pressure, hyperlipidemia, hemoglobin, hematocrit, triglyceride, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and potassium (P < 0.05. Conclusions According to high prevalence of NAFLD in morbidly obese patients undergoing sleeve gastrectomy in Iran, we suggest using gold standard diagnostic method to determine the exact NAFLD prevalence and evaluation of impact of sleeve surgery on NAFLD in short and long term follow-up periods.

  15. Vibrio cholerae bacteremia associated with gastrectomy.

    OpenAIRE

    Toeg, A; Berger, S A; Battat, A; Hoffman, M.; Yust, I

    1990-01-01

    Bacteremia due to Vibrio cholerae is rare. Each of 15 cases previously reported in the English language literature occurred in the setting of immune deficiency. We describe an instance of non-serogroup O1 V. cholerae septicemia in an otherwise healthy patient. Susceptibility to such infection may have been enhanced by a prior gastrectomy for duodenal ulcer.

  16. Vagus effect on pylorus-preserving gastrectomy

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    @@ INTRODUCTION Maki and others reported in 1967 the study of a pylorus-preserving gastrectomy (PPG)[1]. It successfully prevented dumping syndrome and duodenogastric reflux, but failed in gaining proper speed of gastric emptying, thus leading to new complications such as gastric retention, etc. To inquire into this subject, we have made the following experimental studies.

  17. Pressurizer with a mechanically attached surge nozzle thermal sleeve

    Science.gov (United States)

    Wepfer, Robert M

    2014-03-25

    A thermal sleeve is mechanically attached to the bore of a surge nozzle of a pressurizer for the primary circuit of a pressurized water reactor steam generating system. The thermal sleeve is attached with a series of keys and slots which maintain the thermal sleeve centered in the nozzle while permitting thermal growth and restricting flow between the sleeve and the interior wall of the nozzle.

  18. Statistical analysis of friction sleeve length effects on soil classification

    Science.gov (United States)

    Saussus, D. R.; Frost, J. D.; Dejong, J. T.

    2004-10-01

    The cone penetration test (CPT) provides profiles of the tip resistance, sleeve friction, and pore water pressure encountered while penetrating the subsurface. These parameters are used either directly or indirectly to classify the soil types present and to obtain geotechnical design parameters. However, fundamental discrepancies exist in the manner by which these parameters are measured. This paper describes the results of a study that shows the sleeve friction measurement introduces unnecessary redundancy due to the length of the standard friction sleeve compared to the measurement increment. Further, the high sleeve length to measurement increment ratio results in filtering and smoothing of the friction data, thereby causing the variability of the friction between the soil and the cone sleeve to be underestimated. The importance of understanding the role of the sleeve length on measurements is demonstrated using synthetically generated friction profiles and estimating the profiles that would be measured using sleeves of different lengths. Differences in how the soils are classified as a function of the sleeve length used to obtain each profile are illustrated. Solutions are presented to validate the synthetic sleeve friction profiles, to demonstrate the filtering and smoothing effects of the friction sleeve on the data, and to explain the implications of the sleeve length on soil classification. Copyright

  19. Pylorus-Preserving Gastrectomy for Gastric Cancer.

    Science.gov (United States)

    Oh, Seung-Young; Lee, Hyuk-Joon; Yang, Han-Kwang

    2016-06-01

    Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3.0 cm currently, its optimal length still remains unclear. Standard procedures for the preservation of pyloric function, infra-pyloric vessels, and hepatic branch of the vagus nerve, make PPG technically more difficult and raise concerns about incomplete lymph node dissection. The short- and long-term oncological and survival outcomes of PPG were comparable to those for distal gastrectomy, but with several advantages such as a lower incidence of dumping syndrome, bile reflux, and gallstone formation, and improved nutritional status. Gastric stasis, a typical complication of PPG, can be effectively treated by balloon dilatation and stent insertion. Robot-assisted pylorus-preserving gastrectomy is feasible for EGC in the middle-third of the stomach in terms of the short-term clinical outcome. However, any benefits over laparoscopy-assisted PPG (LAPPG) from the patient's perspective have not yet been proven. An ongoing Korean multicenter randomized controlled trial (KLASS-04), which compares LAPPG and laparoscopy-assisted distal gastrectomy for EGC in the middle-third of the stomach, may provide more clear evidence about the advantages and oncologic safety of PPG. PMID:27433390

  20. Pylorus-Preserving Gastrectomy for Gastric Cancer

    Science.gov (United States)

    Oh, Seung-Young; Yang, Han-Kwang

    2016-01-01

    Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3.0 cm currently, its optimal length still remains unclear. Standard procedures for the preservation of pyloric function, infra-pyloric vessels, and hepatic branch of the vagus nerve, make PPG technically more difficult and raise concerns about incomplete lymph node dissection. The short- and long-term oncological and survival outcomes of PPG were comparable to those for distal gastrectomy, but with several advantages such as a lower incidence of dumping syndrome, bile reflux, and gallstone formation, and improved nutritional status. Gastric stasis, a typical complication of PPG, can be effectively treated by balloon dilatation and stent insertion. Robot-assisted pylorus-preserving gastrectomy is feasible for EGC in the middle-third of the stomach in terms of the short-term clinical outcome. However, any benefits over laparoscopy-assisted PPG (LAPPG) from the patient's perspective have not yet been proven. An ongoing Korean multicenter randomized controlled trial (KLASS-04), which compares LAPPG and laparoscopy-assisted distal gastrectomy for EGC in the middle-third of the stomach, may provide more clear evidence about the advantages and oncologic safety of PPG. PMID:27433390

  1. Hiatal Hernia as a Total Gastrectomy Complication

    Directory of Open Access Journals (Sweden)

    Bruna do Nascimento Santos

    2016-02-01

    Full Text Available Introduction: According to the Brazilian National Institute of Cancer, gastric cancer is the third leading cause of death among men and the fifth among women in Brazil. Surgical resection is the only potentially curative treatment. The most serious complications associated with surgery are fistulas and dehiscence of the jejunal-esophageal anastomosis. Hiatal hernia refers to herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm, though this occurrence is rarely reported as a complication in gastrectomy. Case Report: A 76-year-old man was diagnosed with intestinal-type gastric adenocarcinoma. He underwent a total laparoscopic-assisted gastrectomy and D2 lymphadenectomy on May 19, 2015. The pathology revealed a pT4pN3 gastric adenocarcinoma. The patient became clinically stable and was discharged 10 days after surgery. He was subsequently started on adjuvant FOLFOX chemotherapy; however, 9 days after the second cycle, he was brought to the emergency room with nausea and severe epigastric pain. A CT scan revealed a hiatal hernia with signs of strangulation. The patient underwent emergent repair of the hernia and suffered no postoperative complications. He was discharged from the hospital 9 days after surgery. Conclusion: Hiatal hernia is not well documented, and its occurrence in the context of gastrectomy is an infrequent complication.

  2. Performance of Grouted Splice Sleeve Connector under Tensile Load

    Directory of Open Access Journals (Sweden)

    A. Alias

    2016-05-01

    Full Text Available The grouted splice sleeve connector system takes advantage of the bond-slip resistance of the grout and the mechanical gripping of reinforcement bars to provide resistance to tensile force. In this system, grout acts as a load-transferring medium and bonding material between the bars and sleeve. This study adopted the end-to-end rebars connection method to investigate the effect of development length and sleeve diameter on the bonding performance of the sleeve connector. The end-to-end method refers to the condition where reinforcement bars are inserted into the sleeve from both ends and meet at the centre before grout is filled. Eight specimens of grouted splice sleeve connector were tested under tensile load to determine their performance. The sleeve connector was designed using 5 mm thick circular hollow section (CHS steel pipe and consisted of one external and two internal sleeves. The tensile test results show that connectors with a smaller external and internal sleeve diameter appear to provide better bonding performance. Three types of failure were observed in this research, which are bar fracture (outside the sleeve, bar pullout, and internal sleeve pullout. With reference to these failure types, the development length of 200 mm is the optimum value due to its bar fracture type, which indicates that the tensile capacity of the connector is higher than the reinforcement bar. It is found that the performance of the grouted splice sleeve connector is influenced by the development length of the reinforcement bar and the diameter of the sleeve.

  3. Bilateral Tibial Tubercle Sleeve Fractures in a Skeletally Immature Patient

    Directory of Open Access Journals (Sweden)

    Rasesh R. Desai

    2013-01-01

    Full Text Available Tibial tubercle sleeve fracture is a rare injury. In concept, it is similar to the patellar sleeve fracture in a skeletally immature patient. We describe a unique case of simultaneous bilateral tibial tubercle sleeve fractures in a 12-year-old boy. Radiographs and MRI confirmed the injury. The patient underwent open surgical repair of bilateral sleeve fractures with suture anchor fixation. At the final followup, 3 years after his initial injury, the patient demonstrated full knee function bilaterally without radiographic evidence of growth disturbances.

  4. Use of sleeved rolls in a blooming mill

    Science.gov (United States)

    Kuhn, G.

    1983-03-01

    The use of sleeved rolls in the blooming stand ahead of a continuous semifinishing mill is treated. Two sleeved rolls were produced. One comprises a tough steel arbor and the wear resistant roll sleeve of Cr-Ni-Mo-alloyed spheroidal cast iron with carbide. Both parts were joined together in an unstressed manner by adhesive bonding. Tests show that sleeved rolls can be used in blooming stands, thereby increasing their application possibilities, but porosity in the finishing grooves of the rolls caused during the casting process means that long term behavior can not be assessed.

  5. [Survival after gastrectomy for cancer. 209 cases].

    Science.gov (United States)

    Le Treut, Y P; Capobianco, C; Botti, G; Christophe, M; Lebreuil, G; Bricot, R

    1992-09-26

    The long-term results of 209 gastrectomies performed for adenocarcinoma, including 117 which were prospectively collected, are presented. Resection was curative in 154 cases (73.6 percent). The TNM distribution of the tumours was: stage I (TxNOMO) 75 cases, stage II (TxN1MO) 46 cases, stage III (TxN2MO) 33 cases and stage IV (TxNxM1) 55 cases. Lymph node involvement was more frequent in the prospective than in the retrospective study. With a more than 5 years' follow-up of 80 percent of the patients operated upon, the actuarial survival rate at 5 years (operative mortality included) was 38 percent for all lesions, 52 percent for curative resection and 2 percent for palliative resection. Following curative resection, the survival rates for tumours of the upper, middle and lower thirds of the stomach were 40, 60 and 55 percent respectively. These rates were 60 percent for stage I tumours, 54 percent for stage II tumours and 25 percent for stage III tumours. The results obtained in this series, where most of the curative gastrectomies included excision of N1 and N2 lymph nodes, show that lymph node involvement has no significant importance for the prognosis when it is proximal (N1) and is not incompatible with prolonged survival when it is pedicular (N2). PMID:1465364

  6. Function-preserving gastrectomy for gastric cancer in Japan

    Science.gov (United States)

    Nomura, Eiji; Okajima, Kunio

    2016-01-01

    Surgery used to be the only therapy for gastric cancer, and since its ability to cure gastric cancer was the focus of attention, less attention was paid to function-preserving surgery in gastric cancer, though it was studied for gastroduodenal ulcer. Maki et al developed pylorus-preserving gastrectomy for gastric ulcer in 1967. At the same time, the definition of early gastric cancer (EGC) was being considered, histopathological investigations of EGC were carried out, and the validity of modified surgery was sustained. After the development of H2-blockers, the number of operations for gastroduodenal ulcers decreased, and the number of EGC patients increased simultaneously. As a result, the indications for pylorus-preserving gastrectomy for EGC in the middle third of the stomach extended, and various alterations were added. Since then, many kinds of function-preserving gastrectomies have been performed and studied in other fields of gastric cancer, and proximal gastrectomy, jejunal pouch interposition, segmental gastrectomy, and local resection have been performed. On the other hand, from the overall perspective, it can be said that endoscopic resection, which was launched at almost the same time, is the ultimate function-preserving surgery under the current circumstances. The current function-preserving gastrectomies that are often performed and studied are pylorus-preserving gastrectomy and proximal gastrectomy. The reasons for this are that these procedures that can be performed with systemic lymph node dissection, and they include three important elements: (1) reduction of the extent of gastrectomy; (2) preservation of the pylorus; and (3) preservation of the vagal nerve. In addition, these operations are more likely to be performed with a laparoscopic approach as minimally invasive surgery. Of the above-mentioned three elements, reduction of the extent of gastrectomy is the most important in our view. Therefore, we should try to reduce the extent of gastrectomy

  7. Function-preserving gastrectomy for gastric cancer in Japan.

    Science.gov (United States)

    Nomura, Eiji; Okajima, Kunio

    2016-07-14

    Surgery used to be the only therapy for gastric cancer, and since its ability to cure gastric cancer was the focus of attention, less attention was paid to function-preserving surgery in gastric cancer, though it was studied for gastroduodenal ulcer. Maki et al developed pylorus-preserving gastrectomy for gastric ulcer in 1967. At the same time, the definition of early gastric cancer (EGC) was being considered, histopathological investigations of EGC were carried out, and the validity of modified surgery was sustained. After the development of H2-blockers, the number of operations for gastroduodenal ulcers decreased, and the number of EGC patients increased simultaneously. As a result, the indications for pylorus-preserving gastrectomy for EGC in the middle third of the stomach extended, and various alterations were added. Since then, many kinds of function-preserving gastrectomies have been performed and studied in other fields of gastric cancer, and proximal gastrectomy, jejunal pouch interposition, segmental gastrectomy, and local resection have been performed. On the other hand, from the overall perspective, it can be said that endoscopic resection, which was launched at almost the same time, is the ultimate function-preserving surgery under the current circumstances. The current function-preserving gastrectomies that are often performed and studied are pylorus-preserving gastrectomy and proximal gastrectomy. The reasons for this are that these procedures that can be performed with systemic lymph node dissection, and they include three important elements: (1) reduction of the extent of gastrectomy; (2) preservation of the pylorus; and (3) preservation of the vagal nerve. In addition, these operations are more likely to be performed with a laparoscopic approach as minimally invasive surgery. Of the above-mentioned three elements, reduction of the extent of gastrectomy is the most important in our view. Therefore, we should try to reduce the extent of gastrectomy

  8. VATS right upper lobe bronchial sleeve resection

    Science.gov (United States)

    Ma, Qianli

    2016-01-01

    Background The aim of this study is to discuss video-assisted thoracic surgery (VATS) sleeve bronchial lobectomy when handling the locally advanced central lung cancer (involving the trachea and/or main bronchus). Methods A 2.5 cm × 1.0 cm mass was found in the right upper lobe. Bronchoscopy demonstrated the tumor obstructing the right upper lobe bronchus and involved the right main bronchus and bronchus intermedius. Interrupted sutures were chosen for bronchial anastomosis. Bronchial membrane was sutured first, and then circumference end-to-end anastomoses were carried out using 3-0 absorbable sutures. Results There were no complications and the patient was discharged 8 days postoperatively. Conclusions The third intercostal space of the anterior axillary line was suggested for right upper lobe bronchial sleeve resection. This incision can reduce the distance and angle between the anastomosis to the incision, and facilitate anastomosis. This approach can also prevent operator from fatigue for keeping one posture for a long time. Clearance of the mediastinal lymph nodes before cutting the bronchus was helpful for exposing the right main bronchus, the upper lobe bronchus and bronchus intermedius satisfied. And this option would avoid pulling bronchial anastomosis during mediastinal lymph nodes clearance. Interrupted suture was safe and effective for VATS bronchial anastomosis. PMID:27621889

  9. Laparoscopic sleeve gastrectomy using a synthetic bioabsorbable staple line reinforcement material: Post-operative complications and 6 year outcomes

    Directory of Open Access Journals (Sweden)

    Mahdi Saleh

    2016-09-01

    Conclusion: The synthetic bioabsorbable reinforcement material shows no staple line leaks making it safe to use. LSG as a procedure had a high resolution of obesity-related comorbidities as well as sustainable long-term weight loss.

  10. Food intake and nutritional status after gastrectomy

    DEFF Research Database (Denmark)

    Bisballe, S; Buus, S; Lund, B;

    1986-01-01

    Food intake and nutritional status was studied in 67 patients, who had had a gastrectomy 2-30 years earlier, and in a randomly selected, matched group of healthy persons. The gastrectomized patients weighed less than the control persons (women 56.4 +/- 9.5 vs 61.4 +/- 6.9 kg; P less than 0.05; men...... 72.4 +/- 12.5 vs 77.7 +/- 9.2 kg; P less than 0.02). Compared to the controls the gastrectomized women had a significantly lower fat-free mass (37.8 +/- 4.1 vs 40.7 +/- 4.3 kg; P less than 0.02), whereas the gastrectomized men had a lower fat mass (17.0 +/- 7.8 vs 21.2 +/- 6.0 kg; P less than 0...

  11. Uniportal video-assisted thoracoscopic bronchoplastic and carinal sleeve procedures.

    Science.gov (United States)

    Gonzalez-Rivas, Diego; Yang, Yang; Sekhniaidze, Dmitrii; Stupnik, Tomaz; Fernandez, Ricardo; Lei, Jiang; Zhu, Yuming; Jiang, Gening

    2016-03-01

    Despite of the recent advanced with the video-assisted thoracoscopic surgery (VATS), the most common approach for bronchial and carinal resection is still the open surgery. The technical difficulties, the steep learning curve and the concerns about performing an oncologic and safe reconstruction in advanced cases, are the main reasons for the low adoption of VATS for sleeve resections. Most of the authors use 3-4 incisions for thoracoscopic sleeve procedures. However these surgical techniques can be performed by a single incision approach by skilled uniportal VATS surgeons. The improvements of the surgical instruments, high definition cameras and recent 3D systems have greatly contributed to facilitate the adoption of uniportal VATS techniques for sleeve procedures. In this article we describe the technique of thoracoscopic bronchial sleeve, bronchovascular and carinal resections through a single incision approach. PMID:26981273

  12. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available ... of them, and it really depends on the companies. Some insurances will cover the gastric bypass and ... is the band, called the realized band, another product of J&J and Ethicon, correct? Same people ...

  13. EVALUATION OF N-RATIO IN SELECTING PATIENTS FOR ADJUVANT CHEMORADIOTHERAPY AFTER D2-GASTRECTOMY

    OpenAIRE

    Wilson Luiz da COSTA JUNIOR; Felipe Jose Fernandez COIMBRA; Batista, Thales Paulo; RIBEIRO, Heber Salvador de Castro; DINIZ, Alessandro Landskron

    2013-01-01

    Context Whether adjuvant chemoradiotherapy may contribute to improve survival outcomes after D2-gastrectomy remains controvertial. Objective To explore the clinical utility of N-Ratio in selecting gastric cancer patients for adjuvant chemoradiotherapy after D2-gastrectomy. Methods A retrospective cohort study was carried out on gastric cancer patients who underwent D2-gastrectomy alone or D2-gastrectomy plus adjuvant chemoradiotherapy (INT-0116 protocol) at the Hospital A. C. Camargo from...

  14. Experimental study on Bond slip relationship of Steel sleeve

    Directory of Open Access Journals (Sweden)

    Wang J.C.

    2016-01-01

    Full Text Available The assembled concrete structure is usually connected with the steel bar through the sleeve. In order to realize the optimum design of sleeve structure and develop new sleeve, the author put forward a new test method, and made 18 specimens for uniaxial tensile test. Study the influence of the strength of grouting material, diameter of reinforcing steel bar on bond slip relationship between steel bar and grouting material and its failure characteristics by experimental research. This result suggests that with the increase of age, the bond strength between steel bar and grouting material is increasing gradually, the increase speed gradually slowed down after 20 days. For CT20H sleeve, with the increase of the diameter of reinforcement, the bond strength between reinforcement and grouting material increased gradually. Conclusion: In the optimization design of the sleeve, under the premise of ensuring the smooth injection of grouting material and be convenient for the positioning of the reinforced members, reducing the inner diameter of the sleeve can improve the bond strength between reinforcement and grouting material.

  15. Incidence and clinical features of endoscopic ulcers developing after gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Woo Chul Chung; Eun Jung Jeon; Kang-Moon Lee; Chang Nyol Paik; Sung Hoon Jung; Jung Hwan Oh; Ji Hyun Kim

    2012-01-01

    AIM:To determine the precise incidence and clinical features of endoscopic ulcers following gastrectomy.METHODS:A consecutive series of patients who underwent endoscopic examination following gastrectomy between 2005 and 2010 was retrospectively analyzed.A total of 78 patients with endoscopic ulcers and 759 without ulcers following gastrectomy were enrolled.We analyzed differences in patient age,sex,size of the lesions,method of operation,indications for gastric resection,and infection rates of Helicobacter pylori (H.pylori)between the nonulcer and ulcer groups.RESULTS:The incidence of endoscopic ulcers after gastrectomy was 9.3% and that of marginal ulcers was 8.6%.Ulcers were more common in patients with Billroth Ⅱ anastomosis and pre-existing conditions for peptic ulcer disease (PUD).Infection rates of H.pyloridid not differ significantly between the two groups.The patients who underwent operations to treat PUD had lower initial levels of hemoglobin and higher rates of hospital admission.CONCLUSION:H.pylori was not an important factor in ulcerogenesis following gastrectomy.For patients who underwent surgery for PUD,clinical course of marginal ulcers was more severe.

  16. Production of extremely deep sleeves by backward cold extrusion

    Directory of Open Access Journals (Sweden)

    Labanova Nadja

    2015-01-01

    Full Text Available The production of extremely deep sleeves by backward cold extrusion has drawn significant attention and interest in recent years in metal forming area, due to their unique and superior properties and their economic and technological advantages. This work describes the limitation related to buckling of extrusion punch during backward extrusion process and also represents the design of a new tool concept to avoid such risks of effects. Application of this tool concept for many cases in industry provides new opportunities to produce deep sleeves with ratio of the overall height of a sleeve (H to its inner diameter (d higher than three within one process stage by backward cold extrusion. Developed concept of tool has been supported by previous fundamental and applied research studies.

  17. Modification of early postoperative X-ray research after gastrectomy

    Energy Technology Data Exchange (ETDEWEB)

    Sapounov, S.

    1982-10-01

    A modification of the early postoperative X-ray research after gastrectomy is described. The application of gastrografin happens through a nasogastric tube. By changing the position of its tip during the screening control, and excellent and precise represention of the anastomotic region will be achieved. We present a research of 35 patients.

  18. Reconstruction with Jejunal Pouch after Gastrectomy for Gastric Cancer.

    Science.gov (United States)

    Namikawa, Tsutomu; Munekage, Eri; Munekage, Masaya; Maeda, Hiromichi; Kitagawa, Hiroyuki; Nagata, Yusuke; Kobayashi, Michiya; Hanazaki, Kazuhiro

    2016-06-01

    The construction of a gastric substitute pouch after gastrectomy for gastric cancer has been proposed to help ameliorate postprandial symptoms and nutritional performance. Adequate reconstruction after gastrectomy is an important issue, because postoperative patient quality of life (QOL) primarily depends on the reconstruction method. To this end, jejunal pouch (JP) reconstructions were developed to improve the patient's eating capacity and QOL by creating large reservoirs with improved reflux barriers to prevent esophagitis and residual gastritis. It is important that such reconstructions also preserve blood and extrinsic neural integrity for maintaining pouch function, because JP motility is associated directly with QOL. Some problems remain to be resolved with the JP reconstructions method including gastrointestinal motility, which plays a major role in food transfer, digestion, and absorption of nutrients. Further studies including basic research and larger prospective randomized control trials are also needed to obtain definitive results. With persistent innovations in surgical techniques, JP after gastrectomy could become a safe and preferable reconstructive modality to improve patient QOL after gastrectomy. PMID:27305882

  19. Laparoscopic gastric band removal complicated by splenosis.

    Science.gov (United States)

    Nicolas, Gregory; Schoucair, Ramy; Shimlati, Rasha; Rached, Linda; Khoury, George

    2016-08-01

    In any patient, the occurrence of postsplenectomy splenosis can complicate the planning of further surgeries. In our case, the gastric sleeve procedure was aborted, as it would have put the patient's life in danger. Therefore, only the gastric band was removed, eliminating future erosion.

  20. Fatigue Damage Mechanism of Oil Film Bearing Sleeve

    Institute of Scientific and Technical Information of China (English)

    HUANG Qing-xue; WANG Jian-mei; MA Li-feng; ZHAO Chun-jiang

    2007-01-01

    With the rapid development of the steel industry, to keep pace with the current trend of high speed, continuous, and large-scale production that focuses on automation and high levels of efficiency, many state-owned steel companies are being equipped with oil film bearings. Through long-term on-spot inspection and research on the fatigue failure of oil film bearing, three segments of annulated fatigue breakage were found axially along the inner surface of the bearing sleeve. In order to elucidate the reason for the three-segment annulated damage under rolling load, numerical boundary element method was adopted to analyze the contact behaviors between the sleeve and rollneck. Failure mechanism was discussed in detail, the distributions of contact stress were analyzed, and the service lives of the sleeve for different positions on the inner surface were quantitatively described, which provided an effective means to decrease wear and adhesive damage of the sleeve and to increase the load capacity of oil film bearing and its service life as well.

  1. The sleeve monopole antenna in a warm plasma

    International Nuclear Information System (INIS)

    The theoretical analysis of a sleeve monopole antenna which has the length of about plasma wavelength and is placed in an isotropic plasma, was performed in the frequency range where electron plasma waves exist, and the current distribution and the input impedance were obtained. When the Landau attenuation is not considered, the current distribution oscillated largely near the plasma frequency similarly to the case of dipole, and approaches to a triangular distribution with the further increase of the frequency. The input impedance also varies remarkably owing to the sleeve length near the plasma frequency. When the Landau attenuation is considered, the amplitude of the oscillation component of current distribution becomes very small, and it was found that the effect of the sleeve part with the length of 25 times as long as the Debye length was able to be neglected in the input impedance. The results of analysis were compared with the results of experiment. The measured values of input impedance were in good agreement with those of analysis. It was found that the sleeve part, which is an external conductor of a coaxial power line, has the effect to reduce the input impedance. (Kato, T.)

  2. Post-gastrectomy acute pancreatitis in a patient with gastric carcinoma and pancreas divisum

    OpenAIRE

    Kuo, I-Ming; WANG, FRANK; Liu, Keng-Hao; Jan, Yi-Yin

    2009-01-01

    Gastrectomy is commonly performed for both benign and malignant lesions. Although the incidence of post-gastrectomy acute pancreatitis (PGAP) is low compared to other well-recognized post-operative complications, it has been reported to be associated with a high mortality rate. In this article, we describe a 70-year-old man with asymptomatic pancreatic divisum who underwent palliative subtotal gastrectomy for an advanced gastric cancer with liver metastasis. His post-operative course was comp...

  3. Systematic review of feasibility and safety of laparoscopic gastrectomy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Jiwen Jiang

    2012-01-01

    Objective: The purpose of the present study was to retrospectively and systematically evaluate the feasibility and safety of laparoscopic gastrectomy for gastric cancer.Methods: Research of prospective, randomized, controlled studies addressing laparoscopic gastrectomy versus open gastrectomy was screened through computer-based online system.Meta-analysis of acquired data was performed.The inverse variance method was used to test the significance of continuous data, while the Mantel-Haenszel method was used for dichotomous data.The chi-square test was used for evaluation of data heterogeneity.Homogenous data were calculated using the fixed effect model, and heterogeneous data were calculated using freedom model.Statistical data were expressed as 95% confidence interval (95% CI).Funnel plot was used for sensitivity analysis to show potential publication bias.Results: Five papers met the inclusion criteria, 164 cases underwent laparoscopic gastrectomy and 162 cases received open gastrectomy.Meta-analysis revealed that laparoscopic gastrectomy took longer operating time and removed fewer lymph nodes than open gastrectomy (both P < 0.01), but for early-stage gastric cancer, laparoscopic gastrectomy was superior to open gastrectomy in terms of blood loss and hospital stay (P < 0.01).But there were no significant differences in terms of time to resumption of oral intake, postoperative complications, postoperative morbidity rate, and tumor recurrence.Sensitive analysis demonstrated that publication bias existed in all indices to different extents with the exception of lymph node.Subgroup analysis showed that for D1 lymph node dissection, laparoscopic gastrectomy took significantly reduced blood loss than open gastrectomy.Conclusion: All these findings indicate that laparoscopic gastrectomy for early stage gastric cancer is feasible and safe.

  4. Application of purse-string suture for management of duodenal stump in radical gastrectomy

    Institute of Scientific and Technical Information of China (English)

    SHAO Qin-shu; WANG Yong-xiang; YE Zai-yuan; ZHAO Zhong-kuo; XU Ji

    2011-01-01

    Background Gastric cancer (GC) is the second leading cause of cancer mortality worldwide,and surgical resection is currently the only possible curative approach. Duodenal stump leakage is the most serious complication after radical gastrectomy,and optimal treatment is still lacking.Methods We retrospectively reviewed 2034 cases of total or subtotal gastrectomy for GC from January 1995 to December 2009,including 465 cases of duodenal stump closure using purse-string suture (group A),835 cases of duodenal stump treated with linear cutting stapler and seromuscular layer suture (group B),and 734 cases of duodenal stump closure using full-thickness and seromuscular layer suture (group C). We evaluated the surgical cost,operative time for duodenal stump closure,short-term postoperative complications,perioperative blood loss,and postoperative recovery.Results There was no perioperative mortality in any group. Ninety-four postoperative (within 1 month) complications occurred:18 abdominal bleeding,14 anastomotic leakage,15 abdominal infection,36 wound infection,and 11 duodenal stump leakage. There was no significant difference among the groups in intra-abdominal hemorrhage,anastomotic leakage,abdominal infection and wound infection. No postoperative duodenal stump leakage occurred in group A,which had a significant difference compared with groups B and C (6 cases in group B and 5 cases in group C suffered duodenal stump leakage. P <0.01). The surgical cost in groups A and C was significantly lower than in group B (P <0.01),with no significant difference between groups A and C. The processing time for duodenal stump closure in groups A and B was significantly shorter than in group C (P <0.01),with no significant difference between groups A and B. There was no significant difference in blood loss and postoperative recovery among the groups.Conclusions Duodenal stump closure using purse-string suture seems to be a promising approach with shorter operative time,and lower

  5. Totally Laparoscopic Gastrectomy for Gastric Cancer Associated with Recklinghausen's Disease

    Directory of Open Access Journals (Sweden)

    Yoshihisa Sakaguchi

    2010-01-01

    Full Text Available This paper documents the first case of gastric cancer associated with Recklinghausen's disease, which was successfully treated by a totally laparoscopic operation. A 67-year-old woman with Recklinghausen's disease was referred to this department to undergo surgical treatment for early gastric cancer. The physical examination showed multiple cutaneous neurofibromas throughout the body surface, which made an upper abdominal incision impossible. Laparoscopic surgery requiring only small incisions was well indicated, and a totally laparoscopic distal gastrectomy with lymph node dissection was performed. Billroth I reconstruction was done intra-abdominally using a delta-shaped anastomosis. The patient followed a satisfactory postoperative course with no complications. Since the totally laparoscopic gastrectomy has many advantages over open surgery, it should therefore be preferentially used as a less invasive treatment in the field of gastric cancer.

  6. Beneficial effects of continual jejunal interposition after subtotal gastrectomy

    Institute of Scientific and Technical Information of China (English)

    SUN Yuan-shui; YE Zai-yuan; ZHANG Qin; ZHANG Wei; WANG Yuan-yu; L(U) Zhen-ye; XU Ji

    2012-01-01

    Background The ideal post-gastrectomy reconstruction procedure should maintain the normal digestive function and restore intestinal transit to improve the patient quality of life.The aim of this study was to evaluate the effects of integral continual jejunal interposition after subtotal gastrectomy on the nutritional status,glucose levels,and gastric-intestinal motility.Methods The study investigated the effects of the integral continual jejunal interposition,the Billroth Ⅰ and Billroth Ⅱ operations,and the isolated jejunal interposition following subtotal distal gastrectomy on the blood glucose,insulin,routine blood parameters,liver function,and myoelectrical activity in Beagle dogs.Results The weights of the dogs decreased during the first post-operative weeks.Dogs in the integral continual jejunal interposition,Billroth Ⅰ,and Billroth Ⅱ groups gained significantly more weight by 8 weeks.The prognosis nutrition index of the dogs decreased in the first 2 post-operative weeks and increased significantly by 4 weeks in the integral continual jejunal interposition and Billroth Ⅰ groups.The group with duodenal exclusion (Billroth Ⅱ) had significantly higher glucose levels compared to the normal control group.The insulin curve was much higher in dogs that underwent the Billroth Ⅰ,continual jejunal interposition,and isolated jejunal interposition than the Billroth Ⅱ and normal groups.The frequencies of fasting and postprandial jejunal pacesetter potentials (PPs) were greater in the continual jejunal interposition and Billroth Ⅰ groups than that in the isolated jejunal interposition and Billroth Ⅱ groups.The percentage of aboral propagation of PPs was greater in the continual jejunal interposition group than the Billroth Ⅰ,isolated jejunal interposition,and Billroth Ⅱ groups.Conclusion Continual jejunal interposition after subtotal gastrectomy avoids jejunal transection,maintains the duodenal passage and food storage bags,and reduces the influence

  7. A Multifactorial Analysis of Reconstruction Methods Applied After Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Oktay Büyükaşık

    2010-12-01

    Full Text Available Aim: The aim of this study was to evaluate the reconstruction methods applied after total gastrectomy in terms of postoperative symptomology and nutrition. Methods: This retrospective study was conducted on 31 patients who underwent total gastrectomy due to gastric cancer in 2. Clinic of General Surgery, SSK Ankara Training Hospital. 6 different reconstruction methods were used and analyzed in terms of age, sex and postoperative complications. One from esophagus and two biopsy specimens from jejunum were taken through upper gastrointestinal endoscopy from all cases, and late period morphological and microbiological changes were examined. Postoperative weight change, dumping symptoms, reflux esophagitis, solid/liquid dysphagia, early satiety, postprandial pain, diarrhea and anorexia were assessed. Results: Of 31 patients,18 were males and 13 females; the youngest one was 33 years old, while the oldest- 69 years old. It was found that reconstruction without pouch was performed in 22 cases and with pouch in 9 cases. Early satiety, postprandial pain, dumping symptoms, diarrhea and anemia were found most commonly in cases with reconstruction without pouch. The rate of bacterial colonization of the jejunal mucosa was identical in both groups. Reflux esophagitis was most commonly seen in omega esophagojejunostomy (EJ, while the least-in Roux-en-Y, Tooley and Tanner 19 EJ. Conclusion: Reconstruction with pouch performed after total gastrectomy is still a preferable method. (The Medical Bulletin of Haseki 2010; 48:126-31

  8. Sleeve resection for delayed presentation of traumatic bronchial transection.

    LENUS (Irish Health Repository)

    Mohamed, H Y

    2010-02-01

    Tracheobronchial disruption is uncommon in blunt chest trauma. Many of these patients die before reaching the hospital. In the majority of survivors diagnosis is occasionally delayed resulting in complications like airway stenosis and lung collapse. Thus it is important to have radiological follow up after severe thoracic trauma. Sleeve resection can be an excellent option to conserve lung tissue in delayed presentation of bronchial transection.

  9. Elastic Knee Sleeves Limit Anterior Tibial Translation in Healthy Females

    Directory of Open Access Journals (Sweden)

    Robert Csapo, Simona Hosp, Ramona Folie, Robert Eberle, Michael Hasler, Werner Nachbauer

    2016-03-01

    Full Text Available Knee sleeves or braces represent auxiliary tools that have repeatedly been used by athletes, in an attempt to increase knee stability and, thus, reduce the risk of (recurrent ligamentous injuries. Since ACL injuries typically occur in situations involving either torsion or hyperextension of the knee, it has been speculated that braces might protect the ACL by countering excessive anterior translation of the tibia with respect to the femur (Beynnon et al., 1997. However, the preponderance of in vivo studies to test this hypothesis was performed in cohorts of patients suffering from existent ligamentous (Branch et al., 1988; Colville et al., 1986 or other knee injury (Beynnon et al., 1997; Fleming et al., 2000. This complicates the extrapolation of results to healthy subjects. Further, the braces used in these studies were mostly rigid constructs that consisted of either uni- or bilateral hinged bars (Rishiraj et al., 2009. Such braces might hinder performance (Veldhuizen et al., 1991 and would be rejected by the vast majority of healthy athletes. For these reasons, we would like to use this letter to the editor to report the results of our experiments investigating whether a relatively light elastic knee sleeve would limit the degree of anterior tibial translation in computerized arthrometry tests as performed in a sample of non-injured subjects. We recruited ten female college students (age: 23.4 ± 3.2 yrs, height: 1.68 ± 0.05 m, mass: 59.9 ± 5.5 kg who were free of acute or previous injury or any form of orthopaedic disease of the knee joints. The anterior displacement of the tibia was measured using the GNRB® computerized arthrometer (GeNouRob, Laval, France. With subjects lying in the supine position, the lower leg was firmly fixed with plastic caps mounted over the ankle joint and patella. An electrical pressure pad then exerted increasing pressure of up to 250 N on the calf, while a motion sensor, which was positioned on the ventral

  10. The sleeve monopole antenna in a warm plasma

    International Nuclear Information System (INIS)

    Many authors have reported the studies of an unbalanced-fed oblate spheroidal and a spherical antenna immersed in a warm plasma. In their analyses the effect of a transmission line as a radiating element is neglected. In this paper a sleeve monopole antenna which consists of a cylindrical monopole antenna of radius 1mm and a semi-rigid coaxial cable of radius 1.1mm feeding the sleeve is studied in the frequency region of electron plasma wave propagation. The experiments were performed in a cylindrical bell jar with a diameter of 30 cm and a length of 50 cm. The plasma was created by ionizing collisions of energetic electrons with the background argon atoms at pressures of 10/sup -3/ torr. The measured electron temperature and plasma density are about 3-5eV and 10/sup 8/ cm/sup -3/ respectively. The impedance of the sleeve antenna was measured by RF impedance analyzer as a function of frequency

  11. Prophylactic Laparoscopic Total Gastrectomy with Jejunal Pouch Reconstruction in Patients Carrying a CDH1 Germline Mutation

    NARCIS (Netherlands)

    Haverkamp, L.; Sluis, P.C. van der; Ausems, M.G.; Horst, S. van der; Siersema, P.D.; Ruurda, J.P.; Offerhaus, G.J.; Hillegersberg, R. van

    2015-01-01

    BACKGROUND: For patients with an identified germline E-cadherin-1 (CDH1) mutation, prophylactic gastrectomy is the treatment of choice to eliminate the high risk of developing diffuse gastric cancer. Laparoscopic total gastrectomy with jejunal pouch reconstruction is a novel approach that may be esp

  12. Bimetallic sleeve for repairing a heat exchanger tube locally damaged and repairing process of a such tube with this sleeve

    International Nuclear Information System (INIS)

    A tubular sleeve comprising two end sections made of the same metal as the heat exchanger tube and connected by a ring of an alloy suitable for welding is inserted into the tube and welded in place from the inside. The tube and end sections may be of Incoloy 800 while the ring is in Ni-Cr Alloy, Inconel 600 or Inconel 690. 3 figs

  13. Mechanism Research on Melting Loss of Coppery Tuyere Small Sleeve in Blast Furnace

    Science.gov (United States)

    Chai, Yi-Fan; Zhang, Jian-Liang; Ning, Xiao-Jun; Wei, Guang-Yun; Chen, Yu-Ting

    2016-01-01

    The tuyere small sleeve in blast furnace works under poor conditions. The abnormal damage of it will severely affect the performance of the blast furnace, thus it should be replaced during the damping down period. So it is of great significance that we study and reduce the burnout of tuyere small sleeve. Melting loss is one case of its burnout. This paper studied the reasons of tuyere small sleeve's melting loss, through computational simulation and microscopic analysis of the melting section. The research shows that the temperature of coppery tuyere small sleeve is well distributed when there is no limescale in the lumen, and the temperature increases with the thickness of limescale. In addition, the interruption of circulating water does great harm to the tuyere small sleeve. The melting loss of tuyere small sleeve is caused by iron-slag erosion, with the occurrence of the melt metallurgical bonding and diffusion metallurgical combination.

  14. Research and Design of Sleeve Detach and Reunion Drive Mechanism of Screw Melt Extruder Equipment

    Institute of Scientific and Technical Information of China (English)

    Xiude ZHANG

    2012-01-01

    The design of sleeve detach and reunion drive device of screw melt ex- truder equipment was optimized, based on the present installation of hygraulic drive device to achieve the mechanical opening and closing of the sleeve, the dynamic model of the sleeve detach and reunion drive was theoretically measured, and it was verified that the device is simple to operate and convenient to maintain, thus it has great social values.

  15. Control study of arterial interventional chemotherapy before radical gastrectomy for gastric cancer and simple radical gastrectomy for gastric cancer in treatment of advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Bin Liu

    2016-01-01

    Objective: To analyze the differences in effect of arterial interventional chemotherapy before radical gastrectomy for gastric cancer and simple radical gastrectomy for gastric cancer in treatment of advanced gastric cancer.Methods:A total of 86 cases of patients with advanced gastric cancer treated in our hospital were selected as research subjects and randomly divided into two groups, observation group received arterial interventional chemotherapy combined with radical gastrectomy for gastric cancer, control group received simple radical gastrectomy for gastric cancer, and then differences in prognosis-associated factors, MMP and Leptin contents as well as tumor marker and telomerase activity levels of two groups were compared.Results:Serum HER-2/neu ECD level of observation group was lower than that of control group, and serum DKK-1, TS and TP levels were higher than those of control group; at each point in time after treatment, serum CA72-4 and CA50 contents of observation group were lower than those of control group; intraoperative MMP-2, MMP-7, MMP-9 and Leptin levels in gastric cancer tissue of observation group were lower than those of control group; telomerase activity value in gastric cancer tissue of observation group after treatment was lower than that of control group, and both PGⅠ positive expression rate and PGⅠ/ PGⅡ ratio were higher than those of control group.Conclusion: Arterial interventional chemotherapy before radical gastrectomy for gastric cancer can lower tumor malignancy, promote the curative effect of radical gastrectomy for gastric cancer and improve long-term prognosis.

  16. Clinicopathological characteristics and prognosis of early gastric cancer after gastrectomy

    Institute of Scientific and Technical Information of China (English)

    WANG Yong-xiang; SHAO Qin-shu; YANG Qiong; WANG Yuan-yu; YANG Jin; ZHAO Zhong-kuo; XU Ji; YE Zai-yuan

    2012-01-01

    Background Assessment of lymph node metastasis (LNM) is important in early gastric cancer (EGC) and affects treatment decisions.However,the relationship between clinicopathological characteristics and LNM in EGC remains unclear.This study therefore explored favorable predictors of LNM in EGC.Methods A total of 716 specimens from gastric cancer patients who underwent curative gastrectomy between 1996 and 2003 at Zhejiang Provincial People's Hospital were reviewed.Forty-five cases were EGC,and clinicopathological characteristics such as gender,age,tumor size,location,gross type,differentiation,invasion depth,and vessel involvement were assessed to identify predictive factors for LNM and survival time.Results The overall cumulative 5-year survival rate of EGC patients was 88.92%.Among these,22.4% developed LNM,which was associated with a poor 5-year survival rate of only 72.7%.Patients with tumors larger than 2 cm in diameters,with depth of tumor invasion to the submucosa,and with positive lymphatic or nerve involvement were also inclined to have poorer survival performances.EGC limited to the mucosa but poorly differentiated also had a high risk for LNM.Multivariate analysis identified lymphatic invasion and tumor size as independent prognosis factors related to survival in EGC patients.Conclusions Careful planning is required in EGC patients at high risk of lymph node metastases.Endoscopic mucosal resection or endoscopic submucosal dissection and laparoscopic partial gastrectomy should be cautiously used in EGC,and curative gastrectomy including lymphatic dissection and postoperative adjuvant therapy might be considered to improve the prognosis.

  17. Duodenal fistula after gastrectomy: retrospective study of 13 new cases

    Directory of Open Access Journals (Sweden)

    María de los Ángeles Cornejo

    2016-01-01

    Full Text Available Introduction: Duodenal stump fistula (DSF after gastrectomy has a low incidence but a high morbidity and mortality, and is therefore one of the most aggressive and feared complications of this procedure. Material and methods: We retrospectively evaluated all DSF occurred at our hospital after carrying out a gastrectomy for gastric cancer, between January 1997 and December 2014. We analyzed demographic, oncologic, and surgical variables, and the evolution in terms of morbidity, mortality and hospital stay. Results: In the period covered in this study, we performed 666 gastrectomies and observed DSF in 13 patients (1.95%. In 8 of the 13 patients (61.5% surgery was the treatment of choice and in 5 cases (38.5% conservative treatment was carried out. Postoperative mortality associated with DSF was 46.2% (6 cases. In the surgical group, 3 patients developed severe sepsis with multiple organ failure, 2 patients presented a major hematemesis which required endoscopic haemostasis, 1 patient had an evisceration and another presented a subphrenic abscess requiring percutaneous drainage. Six patients (75% died despite surgery, with 3 deaths in the first 24 hours of postoperative care. The 2 patients who survived after the second surgical procedure had a hospital stay of 45 and 84 days respectively. In the conservative treatment group the cure rate was 100% with no significant complications and an average postoperative hospital stay of 39.5 days (range, 26-65 days. Conclusion: FMD is an unusual complication but it is associated with a high morbidity and mortality. In our experience, conservative management has shown better results compared with surgical treatment.

  18. Laser welded sleeving - a proven technology for steam generator life enhancement

    International Nuclear Information System (INIS)

    Laser welded sleeving was performed for the first time in the United States in April 1992 at the J.M. Farley Nuclear Plant Unit 2. In all, 68 tube support plate sleeves and 30 tubesheet sleeves were installed in two steam generators. This was followed by a larger sleeving campaign in the plant's Unit 1 steam generators in October 1992 when 148 tube support plate sleeves and 46 tubesheet sleeves were installed in three steam generators. The successful implementation of this new technology at Farley provides the industry with a field proven and effective option to repair steam generator tubes and maintain operating plant performance. The laser welding was performed using a fiber optic delivery system to transmit light energy from a pulsed solid state laser located outside containment to the weld head which could be positioned remotely in the tubesheet and as high as the sixth support plate in the steam generator. The sleeve material was thermally treated Alloy 690 (UNS 06690). The joint design was a partial penetration, autogenous weld. All free-span welds, namely the support plate sleeve welds and the tubesheet sleeve upper weld, were thermally stress relieved to enhance stress corrosion life. Those welds were also required to pass a stringent ultrasonic test examination. All the processes for laser welded sleeving were performed remotely using the Westinghouse steam generator service robot, ROSA III. The Farley campaigns showed that laser welded sleeving offers a high degree of process control not found with other methods and produces welds that can be fully inspected by ultrasonic examination. They also demonstrated the field hardiness of the sophisticated laser welding system. 5 figs

  19. EFFECTS OF ENTERAL AND PARENTERAL NUTRITION ON GASTROENTERIC HORMONES AND GASTRIC MOTILITY AFTER SUBTOTAL GASTRECTOMY

    Institute of Scientific and Technical Information of China (English)

    Wei-ming Kang; Jian-chun Yu; Qun Zhang; Mei-yun Ke; Jia-ming Qian

    2008-01-01

    Objective To investigate the effects of enteral nutrition (EN) and parenteral nutrition (PN) on gastric motilityand gastroenteric hormones after subtotal gastrectomy.Methods Forty-one patients underwent gastrectomy were randomly divided into EN group ( n = 20) and PN group (n =21 ). From the fast postoperative day to the seventh day, patients received either EN (EN group) or PN (Pnplasma motilin (MTL), and plasma cholecystokinin (CCK) were measured on preoperative day, the fast and seventh postoperative day. Electrogastrography (EGG) was measured on preoperative day and the seventh postoperative day.Results Compared with preoperation, blood GAS, MTL, and CCK levels of 41 patients decreased significantlyon the first day after subtotal gastrectomy (P<0. 001), but returned to the preoperative levels one week later. EGG after gastrectomy showed that gastric basal electrical rhythm was significantly restrained ( P <0. 001 ). On the seventh day after subtotal gastrectomy, plasma MTL and CCK levels in EN group were higher than those in PN group ( P < 0.05 ).There was no difference in GAS level between two groups. EGG in EN group was better than that in PN group postoper-atively.Conclusions The levels of gastroenteritic hormones and the gastric motility decrease significantly after subtotal gastrectomy. In contrast with PN, EN can accelerate the recovery of MTL, CCK, and gastric motility after subtotal gastrectomy.

  20. Nylon Sleeve for Cavity Amplifier Holds Tuning Despite Heat

    Science.gov (United States)

    Derr, Lloyd

    1964-01-01

    The problem: Detuning of cavity amplifiers with change in temperature. This results in deterioration of the performance of the amplifier at its design frequency. In cavity amplifiers and filters it is desirable that constant performance be maintained regardless of thermal changes. These changes often cause an "off resonance shift" in a cavity filter and a deterioration of performance in a cavity amplifier. The solution: Mount the tuning probe in a nylon sleeve. Thermal expansion and contraction of the nylon nullifies unwanted capacitive and inductive changes in the resonant elements.

  1. Laparoscopic and robot-assisted gastrectomy for gastric cancer: Current considerations.

    Science.gov (United States)

    Caruso, Stefano; Patriti, Alberto; Roviello, Franco; De Franco, Lorenzo; Franceschini, Franco; Coratti, Andrea; Ceccarelli, Graziano

    2016-07-01

    Radical gastrectomy with an adequate lymphadenectomy is the main procedure which makes it possible to cure patients with resectable gastric cancer (GC). A number of randomized controlled trials and meta-analysis provide phase III evidence that laparoscopic gastrectomy is technically safe and that it yields better short-term outcomes than conventional open gastrectomy for early-stage GC. While laparoscopic gastrectomy has become standard therapy for early-stage GC, especially in Asian countries such as Japan and South Korea, the use of minimally invasive techniques is still controversial for the treatment of more advanced tumours, principally due to existing concerns about its oncological adequacy and capacity to carry out an adequately extended lymphadenectomy. Some intrinsic drawbacks of the conventional laparoscopic technique have prevented the worldwide spread of laparoscopic gastrectomy for cancer and, despite technological advances in recent year, it remains a technically challenging procedure. The introduction of robotic surgery over the last ten years has implied a notable mutation of certain minimally invasive procedures, making it possible to overcome some limitations of the traditional laparoscopic technique. Robot-assisted gastric resection with D2 lymph node dissection has been shown to be safe and feasible in prospective and retrospective studies. However, to date there are no high quality comparative studies investigating the advantages of a robotic approach to GC over traditional laparoscopic and open gastrectomy. On the basis of the literature review here presented, robot-assisted surgery seems to fulfill oncologic criteria for D2 dissection and has a comparable oncologic outcome to traditional laparoscopic and open procedure. Robot-assisted gastrectomy was associated with the trend toward a shorter hospital stay with a comparable morbidity of conventional laparoscopic and open gastrectomy, but randomized clinical trials and longer follow-ups are

  2. Laparoscopic and robot-assisted gastrectomy for gastric cancer: Current considerations.

    Science.gov (United States)

    Caruso, Stefano; Patriti, Alberto; Roviello, Franco; De Franco, Lorenzo; Franceschini, Franco; Coratti, Andrea; Ceccarelli, Graziano

    2016-07-01

    Radical gastrectomy with an adequate lymphadenectomy is the main procedure which makes it possible to cure patients with resectable gastric cancer (GC). A number of randomized controlled trials and meta-analysis provide phase III evidence that laparoscopic gastrectomy is technically safe and that it yields better short-term outcomes than conventional open gastrectomy for early-stage GC. While laparoscopic gastrectomy has become standard therapy for early-stage GC, especially in Asian countries such as Japan and South Korea, the use of minimally invasive techniques is still controversial for the treatment of more advanced tumours, principally due to existing concerns about its oncological adequacy and capacity to carry out an adequately extended lymphadenectomy. Some intrinsic drawbacks of the conventional laparoscopic technique have prevented the worldwide spread of laparoscopic gastrectomy for cancer and, despite technological advances in recent year, it remains a technically challenging procedure. The introduction of robotic surgery over the last ten years has implied a notable mutation of certain minimally invasive procedures, making it possible to overcome some limitations of the traditional laparoscopic technique. Robot-assisted gastric resection with D2 lymph node dissection has been shown to be safe and feasible in prospective and retrospective studies. However, to date there are no high quality comparative studies investigating the advantages of a robotic approach to GC over traditional laparoscopic and open gastrectomy. On the basis of the literature review here presented, robot-assisted surgery seems to fulfill oncologic criteria for D2 dissection and has a comparable oncologic outcome to traditional laparoscopic and open procedure. Robot-assisted gastrectomy was associated with the trend toward a shorter hospital stay with a comparable morbidity of conventional laparoscopic and open gastrectomy, but randomized clinical trials and longer follow-ups are

  3. Laparoscopic and robot-assisted gastrectomy for gastric cancer: Current considerations

    Science.gov (United States)

    Caruso, Stefano; Patriti, Alberto; Roviello, Franco; De Franco, Lorenzo; Franceschini, Franco; Coratti, Andrea; Ceccarelli, Graziano

    2016-01-01

    Radical gastrectomy with an adequate lymphadenectomy is the main procedure which makes it possible to cure patients with resectable gastric cancer (GC). A number of randomized controlled trials and meta-analysis provide phase III evidence that laparoscopic gastrectomy is technically safe and that it yields better short-term outcomes than conventional open gastrectomy for early-stage GC. While laparoscopic gastrectomy has become standard therapy for early-stage GC, especially in Asian countries such as Japan and South Korea, the use of minimally invasive techniques is still controversial for the treatment of more advanced tumours, principally due to existing concerns about its oncological adequacy and capacity to carry out an adequately extended lymphadenectomy. Some intrinsic drawbacks of the conventional laparoscopic technique have prevented the worldwide spread of laparoscopic gastrectomy for cancer and, despite technological advances in recent year, it remains a technically challenging procedure. The introduction of robotic surgery over the last ten years has implied a notable mutation of certain minimally invasive procedures, making it possible to overcome some limitations of the traditional laparoscopic technique. Robot-assisted gastric resection with D2 lymph node dissection has been shown to be safe and feasible in prospective and retrospective studies. However, to date there are no high quality comparative studies investigating the advantages of a robotic approach to GC over traditional laparoscopic and open gastrectomy. On the basis of the literature review here presented, robot-assisted surgery seems to fulfill oncologic criteria for D2 dissection and has a comparable oncologic outcome to traditional laparoscopic and open procedure. Robot-assisted gastrectomy was associated with the trend toward a shorter hospital stay with a comparable morbidity of conventional laparoscopic and open gastrectomy, but randomized clinical trials and longer follow-ups are

  4. Is prophylactic placement of drains necessary after subtotal gastrectomy?

    Institute of Scientific and Technical Information of China (English)

    Manoj Kumar; Seung Bong Yang; Vijay Kumar Jaiswal; Jay N Shah; Manish Shreshtha; Rajesh Gongal

    2007-01-01

    AIM: To determine the evidence-based values of prophylactic drainage in gastric cancer surgery.METHODS: One hundred and eight patients, who underwent subtotal gastrectomy with D1 or D2 lymph node dissection for gastric cancer between January 2001 and December 2005, were divided into drain group or no-drain group. Surgical outcome and post-operative complications within four weeks were compared between the two groups.RESULTS: No significant differences were observed between the drain group and no-drain group in terms of operating time (171±42 min vs 156±39 min), number of post-operative days until passage of flatus (3.7±0.5d vs 3.5±1.0 d), number of post-operative days until initiation of soft diet (4.9±0.7 d vs 4.8±0.8 d), length of post-operative hospital stay (9.3±2.2 d vs 8.4±2.4 d), mortality rate (5.4% vs 3.8%), and overall postoperative complication rate (21.4% vs19.2%).CONCLUSION: Prophylactic drainage placement is not necessary after subtotal gastrectomy for gastric cancer since it does not offer additional benefits for the patients.

  5. Robotic Gastrectomy: The Current State of the Art

    Science.gov (United States)

    Marano, Alessandra

    2012-01-01

    Since the first laparoscopic gastrectomy for cancer was reported in 1994, minimally invasive surgery is enjoying its wide acceptance. Numerous procedures of this approach have developed, and many patients have benefited from its effectiveness, which has been recently demonstrated for early gastric cancer. However, since laparoscopic surgery is not exempt from some limitations, the robotic surgery system was introduced as a solution by the late 1990's. Many experienced surgeons have embraced this new emerging method that provides undoubted technical and minimally invasive advantages. To date, several studies have concentrated to this new system, and have compared it with open and laparoscopic approach. Most of them have reported satisfactory results concerning the post-operative short-term outcomes, but almost all believe that the role of robotic gastrectomy is still out of focus, especially because long-term outcomes that can prove robotic oncologic equivalency are lacking, and operative costs and time are higher in comparison to the open and laparoscopic ones. This article is a review about the current status of robotic surgery for the treatment of gastric cancer, especially, focusing on the technical aspects, comparisons to other approaches and future prospects. PMID:22792518

  6. Effect of insulator sleeve material on neutron emission from a plasma focus

    International Nuclear Information System (INIS)

    Neutron yield from a small (2 kJ) plasma focus using insulator sleeves of different materials is investigated. Experimental results indicate that the neutron yield from plasma foci may be enhanced several times if an insulator sleeve of higher dielectric constant is employed. (orig.)

  7. Laparoscopic Gastric Sleeve and Micronutrients Supplementation: Our Experience

    Directory of Open Access Journals (Sweden)

    D. Capoccia

    2012-01-01

    Full Text Available Background. Laparoscopic gastric sleeve (LGS has been recently introduced as a stand-alone, restrictive bariatric surgery. Theoretically, LGS attenuates micronutrients deficiencies and associated complications that were typically observed following malabsorptive procedures. The aim of this study was to assess some micronutrients and mineral deficiencies in patients undergoing LGS. Methods. In the period between July 2008 and April 2010, 138 obese patients (110 females and 28 males with mean BMI 44.4 kg/m2 ± 6.5, mean age 43.9±10.9 years were enrolled and underwent LGS. Patients were followed up with routine laboratory tests and anthropometric measurements and assessed for nutritional status, as regards vitamin B12, folic acid, iron, hemoglobin, calcium, and vitamin D, every three months throughout 12 months. Results. 12 months after sleeve, patients did not show iron deficiency and/or anemia; plasma calcium levels were in the normal range without supplementation from the sixth month after the operation. Vitamin B12 and folic acid were adequately supplemented for all the follow-up period. Vitamin D was in suboptimal levels, despite daily multivitamin supplementation. Conclusion. In this study, we showed that LGS is an effective surgery for the management of morbid obesity. An adequate supplementation is important to avoid micronutrients deficiencies and greater weight loss does not require higher dosage of multivitamins.

  8. The effect of waterproofing sleeves on the response of FARMER like ionization chambers

    International Nuclear Information System (INIS)

    According to most recent dosimetry protocols, the determination of the absorbed dose to water for photon and electron beams should be performed with non-water-proof ionization chamber along with plastic waterproofing sleeves whose thickness should be less than 1 mm. In these protocols, the correction for the waterproofing sleeve is incorporated in the equation of the perturbation factor pwall. Many SSDLs and hospitals were previously provided with thicker sleeves and are probably still using them for routine calibrations. The objective of the work presented in this paper is to investigate the effect of the waterproofing sleeves on the response of a WELLHOFER IC 70 ionization chambers in a 60Co and two high energy X-ray beams, 6MV and 18 MV. This chamber is inherently waterproof, thus, the ionisation current obtained with sleeves of different thickness is compared to the current obtained without sleeve. The results are improved by performing, for each thickness, at least two series of measurements with and without sleeve. The results show that with 60Co, the ionization response increases from 0.08% to 0.47% for sleeves from 0.75 mm to 1.75 mm. For 6 MV and 18 MV X-rays, the signal decreases respectively by 0.8% and 1%. When taking into account the perturbation correction factor including the waterproofing sleeve component, the ratio R/Ro , where R is the product of the chamber signal and the perturbation factor (the subscript is for the response without sleeve) is increasing from 0.14% to 0.55% for 60Co. For X-rays, this ratio decreases up to 0.75% and 0.59% respectively for 6 MV and for 18 MV. Similar results are obtained with FARMER like ionization chambers

  9. Post-gastrectomy acute pancreatitis in a patient with gastric carcinoma and pancreas divisum

    Institute of Scientific and Technical Information of China (English)

    I-Ming Kuo; Frank Wang; Keng-Hao Liu; Yi-Yin Jan

    2009-01-01

    Gastrectomy is commonly performed for both benign and malignant lesions. Although the incidence of post-gastrectomy acute pancreatitis (PGAP) is low compared to other well-recognized post-operative complications, it has been reported to be associated with a high mortality rate. In this article, we describe a 70-year-old man with asymptomatic pancreatic divisum who underwent palliative subtotal gastrectomy for an advanced gastric cancer with liver metastasis. His postoperative course was complicated by acute pancreatitis and intra-abdominal sepsis. The patient eventually succumbed to multiple organ failure despite surgical debridement and drainage, together with aggressive antibiotic therapy and nutritional support. For patients with pancreas divisum or dominant duct of Santorini who fail to follow the normal post-operative course after gastrectomy, clinicians should be alert to the possibility of PGAP as one of the potential diagnoses. Early detection and aggressive treatment of PGAP might improve the prognosis.

  10. Laparoscopic Gastrectomy and Transvaginal Specimen Extraction in a Morbidly Obese Patient with Gastric Cancer.

    Science.gov (United States)

    Sumer, Fatih; Kayaalp, Cuneyt; Karagul, Servet

    2016-03-01

    Laparoscopic gastrectomy for cancer has some significant postoperative benefits over open surgery with similar oncologic outcomes. This procedure is more popular in the Far East countries where obesity is not a serious public health problem. In the Western countries, laparoscopic gastrectomy for cancer is not a common procedure, yet obesity is more common. Herein, we aimed to demonstrate the feasibility of laparoscopic gastrectomy for advanced gastric cancer in a morbidly obese patient. Additionally, we used natural orifice specimen extraction as an option to decrease wound-related complications, which are more prevalent in morbidly obese patients. In this case, we performed a fully laparoscopic subtotal gastrectomy with lymph node dissection and Roux-en-Y gastrojejunostomy with the specimen extracted through the vagina. To the best of our knowledge, this was the first report of a natural orifice surgery in a morbidly obese patient with gastric cancer. PMID:27104027

  11. Segmental gastrectomy with radical lymph node dissection for early gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Takeru; Matsuda; Kunihiko; Kaneda; Manabu; Takamatsu; Keishi; Aishin; Masahide; Awazu; Akiko; Okamoto; Katsunori; Kawaguchi

    2010-01-01

    AIM: To describe a new surgical technique and evaluate the early results of segmental gastrectomy (SG) with modified D2 lymph node (LN) dissection for early gastric cancer (EGC). METHODS: Fourteen patients with EGC underwent SG with modified D2 dissection from 2006 to 2008. Their operative results and postoperative courses were compared with those of 17 patients who had distal gastrectomy (DG) for EGC during the same period. RESULTS: Operating time, blood loss, and hospital stay were similar between the 2 g...

  12. Complications after radical gastrectomy following FOLFOX7 neoadjuvant chemotherapy for gastric cancer

    OpenAIRE

    Ren Hui; Wu Qi; Zong Xiang-Long; Wu Xiao-Jiang; Wu Ai-Wen; Bu Zhao-De; Zhang Lian-Hai; Shan Fei; Li Zi-Yu; Ji Jia-Fu

    2011-01-01

    Abstract Background This study assessed the postoperative morbidity and mortality occurring in the first 30 days after radical gastrectomy by comparing gastric cancer patients who did or did not receive the FOLFOX7 regimen of neoadjuvant chemotherapy. Methods We completed a retrospective analysis of 377 patients after their radical gastrectomies were performed in our department between 2005 and 2009. Two groups of patients were studied: the SURG group received surgical treatment immediately a...

  13. Pseudoaneurysm of gastroduodenal artery following radical gastrectomy for gastric carcinoma patients

    Institute of Scientific and Technical Information of China (English)

    Dong Yi Kim; Jae Kyoon Joo; Seong Yeob Ryu; Young Jin Kim; Shin Kon Kim; Yong Yeon Jung

    2003-01-01

    We report a rare case of postoperative pseudoaneurysm of the gastroduodenal artery following radical gastrectomy.Surgical trauma to the gastroduodenal artery during regional lymphadenectomy was considered as the cause of the postoperative pseudoaneurysm. The pseudoaneurysm was successfully managed by ligating the bleeding vessel. We should consider the possibility of pseudoaneurysm formation in a patient with gastrointestinal bleeding in the postoperative period following radical gastrectomy with regional lymph node and perivascular lymphatic dissection.

  14. Risk of Dumping Syndrome after Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: Early Results of a Multicentre Prospective Study.

    Science.gov (United States)

    Ramadan, M; Loureiro, M; Laughlan, K; Caiazzo, R; Iannelli, A; Brunaud, L; Czernichow, S; Nedelcu, M; Nocca, D

    2016-01-01

    Background. Bariatric surgery is an important field of surgery. An important complication of bariatric surgery is dumping syndrome (DS). Aims. To evaluate the incidence of DS in patients undergoing bariatric surgery. Methods. 541 patients included from 5 nutrition and bariatric centers in France underwent either LSG or LRYGB. They were evaluated at 1 month (M1) and 6 months (M6) postoperatively by an interview and completion of a dumping syndrome questionnaire. Results. 268 patients underwent LSG (Group A) and 273 underwent LRYGB. From the LRYGB patients 229 had mechanical gastrojejunoanal anastomosis with 30 mm linear stapler (Group B) and 44 had manual (hand sewn) 15 mm gastrojejunal anastomosis (Group C). Overall incidence of DS was 8.5% at M1 and M6. In LSG group (Group A), only 4 patients (1.49%) reported episodes of DS at M1 and 3 (1.12%) at M6. In Group B, 41 patients (17.90%) reported episodes of DS at M1 and 43 (18.78%) at M6. Group C experienced one case (2.27%) of DS at M1 and none (0%) at M6. Conclusions. Patients undergoing LRYGB, especially with larger gastrojejunal anastomosis, are more prone to developing DS following surgery than patients undergoing LSG or LRYGB with calibrated manual anastomosis. PMID:27242898

  15. [Pre and postoperative adherence to Mediterranean-like diet and its effect on weight loss and cardiovascular risk factors after sleeve gastrectomy].

    Science.gov (United States)

    Ruiz-Tovar, Jaime; Boix, Evangelina; Bozhychko, Maryana; Miren Del Campo, Jone; Martínez, Rosana; Bonete, José María; Calpena, Rafael

    2014-10-01

    Introducción: El cumplimiento de la dieta mediterránea es cada vez menor, incluso en países mediterráneos, a pesar de estar considerada como un ejemplo de dieta saludable. Objetivos: El objetivo principal de este trabajo fue evaluar la adherencia a la dieta mediterránea en pacientes obesos mórbidos antes y después de ser sometidos a una gastrectomía vertical como técnica bariátrica. Así mismo, se analizó también la influencia de la adherencia sobre la pérdida de peso conseguida y sobre la evolución de los factores de riesgo cardiovasculares. Material y métodos: Se realizó un estudio observacional prospectivo de todos los pacientes sometidos a una gastrectomía vertical entre octubre de 2010 y mayo de 2012. Los pacientes rellenaron un test KIDMED (evalúa la adherencia a la dieta mediterránea) antes de la operación y 1 año después de la misma. Resultados: Se incluyeron un total de 50 pacientes en el estudio. Antes de la operación, el 30% de los pacientes estudiados presentaban una baja adherencia a la dieta mediterránea, el 64% una adherencia moderada y sólo un 6% una buena adherencia. Al año de la intervención, sólo un 2% de los casos presentaban una baja adherencia, un 58% una adherencia moderada y un 40% una buena adherencia a la dieta mediterránea (p=0,02). Se estableció una correlación inversa entre el aumento de puntuación del test KIDMED (indicador de mayor adherencia a la dieta mediterránea) y la pérdida de peso (Spearman -0,357; p=0,008), el descenso en los valores de colesterol total (Spearman -0,442; p=0,003) y de LDL-colesterol (Spearman -0,464; p=0,002). Además, se observó una correlación directa entre el aumento de puntuación del test KIDMED y el incremento en los niveles de HDL-colesterol (Spearman 0,562; p=0,001). Conclusiones: Después de la operación, los pacientes cumplen mejor los patrones de dieta mediterránea. Aquellos pacientes con mejor adherencia a la misma, consiguieron una mayor pérdida de peso y una mejoría significativa del perfil lipídico.

  16. Assessment of Surgical Complications in Morbid Obese Patients, The Candidates for 2 Methods of Laparoscopic Bariatric Surgery (Laparoscopic Gastric Bypass, Laparoscopic Sleeve Gastrectomy

    Directory of Open Access Journals (Sweden)

    Pazouki

    2015-11-01

    Full Text Available Background In 2005, obesity rate was declared 396 million worldwide, which has been doubled in the last 20 years (compared with 1985. Obesity has a strong correlation with a pool of comorbidities and consequences. Although many modules, including behavioural approach and medications have presented particular short-term unreliable methods to reduce and control the body weight in morbid obesity, only 5 - 10% of weight loss was achieved, which is usually regained overtime, compared with 50 - 75% success rate in bariatric surgery. Objectives This retrospective study tried to monitor weight loss after LRYGB and LSG in morbid obese patients referred to a known center in Tehran through a one-year follow up. Materials and Methods Participants were selected regarding the U.S. National Institute of Health (NIH guidelines, which indicates BMI > 40 kg/m2 alone, or BMI > 35 kg/m2 in addition to comorbidities and failure of non-surgical attempts to control their weight. They were visited at points of one, three, six, and 12 months postoperatively to collect information about weight loss, BMI, and complications in addition to percent excess weight loss (EWL%. The percentage of failure was computed to the proportion of patients who had EWL% < 25 to the total number of operated patients in a year. Results Significant decrease in BMI and weight were achieved in all postoperative visits (for all of them, P value < 0.0001, while no significant difference was found in which the parameters between two studied procedures were in this regard. Conclusions To sum up, LRYGB and LSG deserve an overall preference not only in current study, but also in the majority of performances up to now. Nevertheless it is urgent the relevant studies to confirm the preference or improve this kind of bariatric surgery in order to diminish complications as far as possible.

  17. Prophylactic total gastrectomy in hereditary diffuse gastric cancer

    DEFF Research Database (Denmark)

    Bardram, Linda; Hansen, Thomas V O; Gerdes, Anne-Marie;

    2014-01-01

    Inactivating mutations in the CDH1 (E-cadherin) gene are the predisposing cause of gastric cancer in most families with hereditary diffuse gastric cancer (HDGC). The lifetime risk of cancer in mutation positive members is more than 80 % and prophylactic total gastrectomy is recommended. Not all...... mutations in the CDH1 gene are however pathogenic and it is important to classify mutations before this major operation is performed. Probands from two Danish families with gastric cancer and a history suggesting HDGC were screened for CDH1 gene mutations. Two novel CDH1 gene mutations were identified....... Hospital stay was 6-8 days and there were no complications. Small foci of diffuse gastric cancer were found in all patients-intramucosal in six and advanced in one. Preoperative endoscopic biopsies had revealed a microscopic cancer focus in two of the patients. Our data confirmed the pathogenic nature...

  18. Ataxic gait following total gastrectomy for gastric cancer

    Science.gov (United States)

    Hwang, Chang Ho; Park, Dong Jin; Kim, Gyu Yeol

    2016-01-01

    A 58-year-old woman, who had undergone total gastrectomy for early gastric cancer 9 years previously, visited the outpatient clinic complaining of progressive difficulty in walking for 15 d. Laboratory examinations showed macrocytic anemia and a decreased serum vitamin B12 concentration and increased serum concentrations of folate, vitamin E and copper. Magnetic resonance imaging showed multifocal high signal intensities along the posterior column of the cervical and thoracic spinal cord. Treatment consisted of intramuscular injections of vitamin B12 for 7 d, which increased her serum level of vitamin B12 to normal. This was followed by weekly intramuscular injections of vitamin B12 for another 2 wk and oral administration of vitamin B12 three times per day. After comprehensive rehabilitation for 4 wk, she showed sufficient improvements in strength and ataxic gait, enabling her to return to her normal daily activities. PMID:27729749

  19. Additional Gastrectomy after Endoscopic Submucosal Dissection for Early Gastric Cancer Patients with Comorbidities

    Directory of Open Access Journals (Sweden)

    Naohiko Koide

    2012-01-01

    Full Text Available Purpose. We investigated the clinicopathologic features of early gastric cancer (EGC patients who have undergone additional gastrectomy after endoscopic submucosal dissection (ESD because of their comorbidities. Methods. Eighteen (7.1% of 252 GC patients were gastrectomized after prior ESD. Reasons for further surgery, preoperative and postoperative problems, and the clinical outcome were determined. Results. The 18 patients had submucosal EGC and several co-morbidities. Other primary cancers were observed in 8 (44.4%. Histories of major abdominal operations were observed in 6 (33.3%. Fourteen patients (77.8% hoped for endoscopic treatment. Due to additional gastrectomy, residual cancer was suspected in 10, and node metastasis was suspected in 11. A cancer remnant was histologically observed in one. Node metastasis was detected in 3 (16.7%. Small EGC was newly detected in 4. Consequently, additional gastrectomy was necessary for the one third. No patient showed GC recurrence. However, 9 (50% had new diseases, and 4 (22.2% died of other diseases. The overall survival after surgery in these patients with additional gastrectomy was poorer than those with routine gastrectomy for submucosal EGC (=0.0087. Conclusions. Additional gastrectomy was safely performed in EGC patients with co-morbidities. However, some issues, including presence of node metastasis and other death after surgery, remain.

  20. Reconstruction of the esophagojejunostomy by double stapling method using EEA™ OrVil™ in laparoscopic total gastrectomy and proximal gastrectomy

    Directory of Open Access Journals (Sweden)

    Yano Seiji

    2011-05-01

    Full Text Available Abstract Here we report the method of anastomosis based on double stapling technique (hereinafter, DST using a trans-oral anvil delivery system (EEATM OrVilTM for reconstructing the esophagus and lifted jejunum following laparoscopic total gastrectomy or proximal gastric resection. As a basic technique, laparoscopic total gastrectomy employed Roux-en-Y reconstruction, laparoscopic proximal gastrectomy employed double tract reconstruction, and end-to-side anastomosis was used for the cut-off stump of the esophagus and lifted jejunum. We used EEATM OrVilTM as a device that permitted mechanical purse-string suture similarly to conventional EEA, and endo-Surgitie. After the gastric lymph node dissection, the esophagus was cut off using an automated stapler. EEATM OrVilTM was orally and slowly inserted from the valve tip, and a small hole was created at the tip of the obliquely cut-off stump with scissors to let the valve tip pass through. Yarn was cut to disconnect the anvil from a tube and the anvil head was retained in the esophagus. The end-Surgitie was inserted at the right subcostal margin, and after the looped-shaped thread was wrapped around the esophageal stump opening, assisting Maryland forceps inserted at the left subcostal and left abdomen were used to grasp the left and right esophageal stump. The surgeon inserted anvil grasping forceps into the right abdomen, and after grasping the esophagus with the forceps, tightened the end Surgitie, thereby completing the purse-string suture on the esophageal stump. The main unit of the automated stapler was inserted from the cut-off stump of the lifted jejunum, and a trocar was made to pass through. To prevent dropout of the small intestines from the automated stapler, the automated stapler and the lifted jejunum were fastened with silk thread, the abdomen was again inflated, and the lifted jejunum was led into the abdominal cavity. When it was confirmed that the automated stapler and center rod

  1. Investigation after one cycle on Doel 3 tubes sleeved by Westinghouse

    International Nuclear Information System (INIS)

    At DOEL 3, 55 SG-tubes cracked at the roll transition area were repaired by Westinghouse in 1988 by CO2 laser welded sleeving, with a post weld stress relief. After one cycle two sleeved tubes were pulled out for investigation. The main purpose of this investigation was the correlation with the on-site UT-inspection, performed after sleeving, because surface irregularities of the weld had disturbed the determination of the weld penetration for several tubes. A good correlation between the UT-results and the direct examination is found for the two tubes which are both affected by surface irregularities on the majority of the circumference. Another important goal of the investigation is the verification of the resistance to primary water stress corrosion cracking of the upper joint of the sleeve, namely at the upper transition area and near the weld because the parent tube is very susceptible to this corrosion and because residual stresses could remain after the complete sleeving process. After one year no tube nor sleeve degradation could be observed so that it was decided to maintain the remaining sleeved tubes in service

  2. Validation of sleeve of straight union type B for leaks

    Energy Technology Data Exchange (ETDEWEB)

    Teutonico, Mauricio; Fazzini, Pablo [Gie S.A., Buenos Aires (Argentina)

    2009-07-01

    Analytic study and experimental validation of type B sleeve with overlapping, were done in order to determine whether they are suitable for used as permanent leaks repair in hydrocarbons transport lines. All relevant background of this type of repair was analyzed, following the guidelines defined by applicable regulations (ASME B31.8 and ASME B31.4) and modeled by finite elements methods. Solicitations under internal pressure of each one of the reinforcement parts were analyzed. All solicitations involved in welded unions were studied, so as the reinforcement effectiveness when it is filled with internal gap filler. Experimental tests were developed, consisted on the reinforcement installation upon damaged pipes and the following hydrostatic test. These tests were assisted by a digitalized measurement, to determine the solicitations at different parts of the reinforcement; strain gauges were used for this task. (author)

  3. Numerical investigation of soil plugging effect inside sleeve of cast-in-place piles driven by vibratory hammers in clays.

    Science.gov (United States)

    Xiao, Yong Jie; Chen, Fu Quan; Dong, Yi Zhi

    2016-01-01

    During driving sleeve of cast-in-place piles by vibratory hammers, soils were squeezed into sleeve and then soil plugging was formed. The physic-mechanical properties of the soil plug have direct influence on the load transmission between the sleeve wall and soil plug. Nevertheless, the researches on this issue are insufficient. In this study, finite element and infinite element coupling model was introduced, through the commercial code ABAQUS, to simulate the full penetration process of the sleeve driven from the ground surface to the desired depth by applying vibratory hammers. The research results indicated that the cyclic shearing action decreases both in soil shear strength and in granular cementation force when the sleeve is driven by vibratory hammers, which leads to a partially plugged mode of the soil plug inside the sleeve. Accordingly, the penetration resistance of sleeve driven by vibratory hammers is the smallest compared to those by other installation methods. When driving the sleeve, the annular soil arches forming in the soil plug at sleeve end induce a significant rise in the internal shaft resistance. Moreover, the influence of vibration frequencies, sleeve diameters, and soil layer properties on the soil plug was investigated in detail, and at the same time improved formulas were brought forward to describe the soil plug resistance inside vibratory driven sleeve. PMID:27386238

  4. Immediate effects of an elastic knee sleeve on frontal plane gait biomechanics in knee osteoarthritis.

    Directory of Open Access Journals (Sweden)

    Raphael Schween

    Full Text Available Osteoarthritis of the knee affects millions of people. Elastic knee sleeves aim at relieving symptoms. While symptomatic improvements have been demonstrated as a consequence of elastic knee sleeves, evidence for biomechanical alterations only exists for the sagittal plane. We therefore asked what effect an elastic knee sleeve would have on frontal plane gait biomechanics.18 subjects (8 women, 10 men with osteoarthritis of the medial tibiofemoral joint walked over ground with and without an elastic knee sleeve. Kinematics and forces were recorded and joint moments were calculated using an inverse dynamics approach. Conditions with sleeve and without sleeve were compared with paired t-Tests.With the sleeve, knee adduction angle at ground contact was reduced by 1.9 ± 2.1° (P = 0.006. Peak knee adduction was reduced by 1.5 ± 1.6° (P = 0.004. The first peak knee adduction moment and positive knee adduction impulse were decreased by 10.1% (0.74 ± 0.9 Nm • kg-1; P = 0.002 and 12.9% (0.28 ± 0.3 Nm • s • kg-1; P < 0.004, respectively.Our study provides evidence that wearing an elastic knee sleeve during walking can reduce knee adduction angles, moments and impulse in subjects with knee osteoarthritis. As a higher knee adduction moment has previously been identified as a risk factor for disease progression in patients with medial knee osteoarthritis, we speculate that wearing a knee sleeve may be beneficial for this specific subgroup.

  5. Gastrectomy is Associated with an Increased Risk of Pyogenic Liver Abscess: A 13-Year Nationwide Cohort Study

    Science.gov (United States)

    Tsai, Ming-Shian; Lin, Cheng-Li; Jeng, Long-Bin

    2016-01-01

    Whether patients who have undergone gastrectomy are at a high risk of developing pyogenic liver abscess (PLA) remains debatable. From the inpatient claims records of Taiwan’s National Health Insurance Research Database, we identified 33 834 patients with a history of 2000–2010 and135 336 controls without a history of gastrectomy. The 2cohorts were matched by age, sex, and admission year and followed-up until the end of 2011 for estimating the risk of PLA. Overall, the incidence of PLA was 3.5-fold higher in the gastrectomy cohort than in the control cohort (21.6 vs 5.76 per 10 000 person-y). The adjusted hazard ratio (aHR) for the gastrectomy cohort obtained using the multivariate Cox proportional hazards regression model was 3.08 (95% confidence interval [CI] = 2.60–3.64). An elevated post gastrectomy PLA risk was observed in both men and women. Age-specific data revealed that the aHR for the gastrectomy cohort, compared with the control cohort, was the highest in patients younger than 50 years (aHR = 5.16, 95% CI = 2.96–9.01). An addition analysis showed that the gastrectomy cohort exhibited an elevated PLA risk regardless of whether the patients underwent total or partial gastrectomy. Patients with a history of gastrectomy exhibit a high risk of PLA. PMID:27671754

  6. Simulation on Mechanical Behaviors of Oil-film Bearing Sleeve by Elastic Interference Fit

    Institute of Scientific and Technical Information of China (English)

    HUANG Qingxue; WANG Jianmei; ZHAO Chunjiang; MA Lifeng

    2006-01-01

    Oil film bearing, which works on thin film between sleeve and bush, is widely used in steel industry due to the characteristics of high efficiency and low noise, etc. The backup roll of 1 580PC hot strip mill invested by some steel corporation has been equipped with such bearing. During the process of setup&disassembly and usage period, the sleeve has been dramatically damaged, which results in production accidents and decreases its service life, thus heavily influencing steel production. Aimed at such puzzles, under specific loadcase, mechanical properties of bearing sleeve, as well as estimation of contact status and adhesive force of sleeve by interference fit, are quantitatively simulated by finite element method, which establishes an mechanical foundation for improving the load capacity of bearing and decreasing its wear and adhesion damages. Finally, some measures and conclusions are drawn.

  7. The effects of stochastic resonance electrical stimulation and neoprene sleeve on knee proprioception

    OpenAIRE

    Olcott Chris W; Blackburn J Troy; Collins Amber T; Dirschl Douglas R; Weinhold Paul S

    2009-01-01

    Abstract Background A variety of knee injuries and pathologies may cause a deficit in knee proprioception which may increase the risk of reinjury or the progression of disease. Stochastic resonance stimulation is a new therapy which has potential benefits for improving proprioceptive function. The objective of this study was to determine if stochastic resonance (SR) stimulation applied with a neoprene sleeve could improve knee proprioception relative to a no-stimulation/no-sleeve condition (c...

  8. Investigation after one cycle on DOEL 3 tubes sleeved by Westinghouse

    International Nuclear Information System (INIS)

    At DOEL 3, 55 steam generator tubes cracked at the roll transition were repaired by Westinghouse in 1988 by CO2 laser welded sleeving, with post weld stress relieving. After one cycle, two sleeved tubes were pulled out for examination. The main purpose of this examination was the correlation with the on-site ultrasonic inspection performed after sleeving, because surface irregularities of the weld had interfered with the determination of weld penetration in the case of several sleeves. Good correlation between the ultrasonic results and the direct examination was found for the two tubes, which are both affected by surface irregularities on the majority of the circumference. Another important goal of the examination is the verification of the resistance to primary water stress corrosion cracking of the upper joint of the sleeve. After one year's service, no degradation was observed so that it was decided to keep all the other sleeves in service. This examination also shows the differences between the pulled-out tubes and the laboratory models examined beforehand, which highlights the problem of the reproducibility of such a process. (author)

  9. Two-incision approach for video-assisted thoracoscopic sleeve lobectomy treating the central lung cancer

    Directory of Open Access Journals (Sweden)

    X Wang

    2014-01-01

    Full Text Available Background: We review our experiences with video-assisted thoracoscopic surgery (VATS sleeve lobectomy with bronchoplasty for nonsmall-cell lung cancer, using only two incisions. The aim of this study was to evaluate the technical feasibility and safety of surgical approach. Materials and Methods: From January 2013 to January 2014, we completed 15 cases of VATS sleeve lobectomy with bronchoplasty in our hospital. The patients underwent sleeve lobectomy with bronchoplasty at the following locations: right upper lobe (n = 4, right lower and middle lobes (n = 1, left lower lobe (n = 5, and left upper lobe (n = 6. The operation consisted of VATS anatomic sleeve lobectomy with bronchoplasty combined with systematic lymph node dissection, using only two incisions. Results: The patients underwent sleeve lobectomy with bronchoplasty were no postoperative complications. Median operative time was 183 min; median bronchial anastomosis time was 39 min; median blood loss was 170 ml. Pathological examination showed 12 squamous cell carcinomas and 3 adenocarcinoma. Median postoperative chest tube drainage duration was 4.5 days, and median hospital stay was 6.9 days. Conclusions: Video-assisted thoracoscopic surgery sleeve lobectomy with bronchoplasty is a feasible and safe surgical approach, using only two incisions. This way of operation can promote the development of surgical technology.

  10. Influence of Gastrectomy on Cortical and Cancellous Bones in Rats

    Directory of Open Access Journals (Sweden)

    Jun Iwamoto

    2013-01-01

    Full Text Available The aim of the present study was to examine the influence of gastrectomy (GX on cortical and cancellous bones in rats. Twenty male Sprague-Dawley rats were randomized into the two groups of 10 animals each: a sham operation (control group and a GX group. Seven weeks after surgery, the bone mineral content and density (BMC and BMD, resp. and the mechanical strength of the femur were determined, and bone histomorphometric analyses were performed on the tibia. GX induced decreases in the BMC, BMD, ultimate force, work to failure, and stiffness of the femoral distal metaphysis and the BMC, BMD, and ultimate force of the femoral diaphysis. GX induced a decrease in cancellous bone mass, characterized by an increased osteoid thickness, osteoid surface, osteoid volume, and bone formation. GX also induced a decrease in cortical bone mass, characterized by increased endocortical bone resorption. The GX induced reductions in the bone mass and strength parameters were greater in cancellous bone than in cortical bone. The present study showed that the response of bone formation, resorption, and osteoid parameters to GX and the degree of GX-induced osteopenia and the deterioration of bone strength appeared to differ between cortical and cancellous bones in rats.

  11. Laparoscopy-assisted versus open gastrectomy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Objective:A meta-analysis of high-quality clinical studies was performed to compare LAG and open gastrectomy (OG) for AGC.Methods: Meta-analysis was performed using RevMan 5.0 software (Cochrane Library). Results:Twenty studies were included in final pooled analysis, 2RCTs and 17 NRCTs, compromising 3,409 patients (1,640 LAG, 1,709 OG). LAG was associated with longer operative time(P<0.001) and lower overall complications(P=0.001), estimated blood loss(P<0.001) and hospital stay(P<0.001). hTere were no signiifcant differences between two groups in number of lymph node dissection (P=0.65), overall complication (P=0.86), a 5-year overall survival rate (P=0.53) and 5-year recurrence-free survival (P=0.07).Conclusion:Despite a longer operation time, LAG is a safe technical alternative to OG for AGC with a lower complication rate and enhanced postoperative recovery. Moreover, the oncologic outcomes of LAG for AGC patients were comparable with open approach.

  12. Post-gastrectomy patients need to be followed up for 20-30 years

    Institute of Scientific and Technical Information of China (English)

    Frank I. Tovey; Michael Hobsley

    2000-01-01

    AIM To investigate the incidence andmanagement of nutritional deficiencies followinga gastrectomy.METHODS A gastrectomy population of 227patients in London was followed up for 30 years after operation to detect and treat nutritional deficiencies.RESULTS By the end of the first decade iron deficiency was the commonest problem. Vitamin B12 deficiency became more important in the second decade. During the third decade both reached equal prevalence, being found in some 90% of the female and 70% of the male residual population. Vitamin D deficiency was a lesser problem, reaching its climax in the second decade. Overall, all women fared worse than men.CONCLUSION The importance of long-term follow-up of gastrectomy patients for iron,Vitamin B12 and Vitamin D deficiencies is emphasised.

  13. Secondary omental infarction related to open and laparoscopic-assisted distal gastrectomy: report of two cases.

    Science.gov (United States)

    Park, Kyung Eun; Chung, Dong Jin; Kim, Wook; Hahn, Seong-Tae; Lee, Jae Moon

    2011-01-01

    Omental infarction occurring after open and laparoscopic-assisted distal gastrectomy with partial omentectomy for gastric cancer was a very rare disease in the past, but its incidence has increased as more partial omentectomies are now being performed. But there are few case reports or radiologic studies on its increasing incidence. It is necessary to differentiate omental infarction from carcinomatosis peritonei, since both have similar imaging findings. In this report, we describe two cases of omental infarction; each occurred after open and laparoscopic-assisted distal gastrectomy in early gastric cancer patients. Partial omentectomy was performed in both cases. Omental infarction following distal gastrectomy with partial omentectomy can be discriminated from carcinomatosis peritonei by comparing with different initial and follow up CT findings.

  14. Evaluation of the pylorusfunction after pylorus-preserving distal gastrectomy by the gastrointestinal and biliary scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Inada, Takao; Ogata, Yoshiro; Yamamoto, Seichiro; Ando, Jiro; Ozawa, Iwao; Matsui, Junichi; Hishinuma, Shoichi; Shimizu, Hideaki; Kotake, Kenjiro [Tochigi Cancer Center (Japan)

    1999-07-01

    The postoperative function of pylorus-preserving distal gastrectomy (PPDG) was analyzed by gastrointestinal and biliary scintigraphy in 8 patients and compared with that of pre-operative control and conventional distal gastrectomy with Billroth-1 reconstruction (B-1) groups. The mean evacuation times of bile to duodenum of three groups had no significant differences and in the PPDG group, there was no difference in bile evacuation between the pre-and postoperative periods. The regurgitation of bile to the rest stomach was observed in more than 40% of the B-1 group, but was seldom observed in the PPDG group and control group. Gastric emptying after pylorus-preserving distal gastrectomy assessed by gastrointestinal scintigraphy was significantly slower than the control at 6 months after surgery, however, this difference was no longer observed 1 year after surgery. Therefore, pyloric function after PPDG was observed to improve gradually after the surgery. (author)

  15. EVALUATION OF N-RATIO IN SELECTING PATIENTS FOR ADJUVANT CHEMORADIOTHERAPY AFTER D2-GASTRECTOMY

    Directory of Open Access Journals (Sweden)

    Wilson Luiz da COSTA JUNIOR

    2013-12-01

    Full Text Available Context Whether adjuvant chemoradiotherapy may contribute to improve survival outcomes after D2-gastrectomy remains controvertial. Objective To explore the clinical utility of N-Ratio in selecting gastric cancer patients for adjuvant chemoradiotherapy after D2-gastrectomy. Methods A retrospective cohort study was carried out on gastric cancer patients who underwent D2-gastrectomy alone or D2-gastrectomy plus adjuvant chemoradiotherapy (INT-0116 protocol at the Hospital A. C. Camargo from September 1998 to December 2008. Statistical analysis were performed using multiple conventional methods, such as c-statistic, adjusted Cox's regression and stratified survival analysis. Results Our analysis involved 128 patients. According to c-statistic, the N-Ratio (i.e., as a continuous variable presented “area under ROC curve” (AUC of 0.713, while the number of metastatic nodes presented AUC of 0.705. After categorization, the cut-offs provide by Marchet et al. displayed the highest discriminating power – AUC value of 0.702. This N-Ratio categorization was confirmed as an independent predictor of survival using multivariate analyses. There also was a trend of better survival by adding of adjuvant chemoradiotherapy only for patients with milder degrees of lymphatic spread – 5-year survival of 23.1% vs 66.9%, respectively (HR = 0.426, 95% CI 0.150–1.202; P = 0.092. Conclusions This study confirms the N-Ratio as a tool to improve the lymph node metastasis staging in gastric cancer and suggests the cut-offs provided by Marchet et al. as the best way for its categorization after a D2-gastrectomy. In these settings, the N-Ratio appears a useful tool to select patients for adjuvant chemoradiotherapy, and the benefit of adding this type of adjuvancy to D2-gastrectomy is suggested to be limited to patients with milder degrees of lymphatic spread (i.e., NR2, 10%–25%.

  16. Comparative Study on the Difference in Functional Outcomes at Discharge between Proximal and Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Kazuaki Kuwabara

    2012-06-01

    Full Text Available Several studies have regarded proximal gastrectomy (PG as optimal compared to total gastrectomy (TG for upper stomach cancer. In addition to the traditional outcomes of complication and mortality, change in functional status should be considered as another relevant outcome in aging generations. However, there has been no community-based appraisal of functional outcomes between PG and TG. Using an administrative database, we compared functional outcomes between PG and TG. Among 12,508 patients who survived for ≥15 years and underwent open gastrectomy between 2008 and 2010, we examined patient characteristics, comorbidities, functional status estimated by the Barthel index (BI at admission and discharge, complications, ICU care, ventilation administration, blood transfusion, operating room time, resumption of oral intake, length of stay and total charges. With reference to distal gastrectomy (DG, we performed multivariate analyses to assess the impacts of PG and TG on complications and BI deterioration. A total of 434 PGs and 4,941 TGs were observed in 148 and 295 hospitals, respectively. Patient characteristics, care process, resumption of oral intake, operating room time, length of stay and total charges were also significantly different among the three gastrectomy types. PG, TG and DG were not associated with complications or functional deterioration. Patient characteristics, preoperative blood transfusion and longer operating room time were significantly associated with more complications and BI deterioration. Since patient case mix and longer operating room time were associated with poor outcomes, physicians should recognize the role of PG and might optimally challenge and complete gastrectomies within the appropriate indications.

  17. Morbidity and mortality after neoadjuvant therapy and sleeve lobectomyin N2-disease

    Directory of Open Access Journals (Sweden)

    Corinna LUDWIG

    2008-10-01

    Full Text Available Background and objective Sleeve resections were introduced to preserve lung function in patients with limited pulmonary reserve. Increasing experience with sleeve resection has reduced the rate of pneumonectomy below 10%. The aim of the study was to assess the outcome after neoadjuvant chemo- or chemoradiotherapy and sleeve resection in patients with N2 non-small cell lung cancer. Methods Retrospective analysis of 41 patient records between 01.01.2005 and 31.12.2007 underwent induction therapy in N2-disease followed by tracheobronchial sleeve resection. These patients were compared to the overall results after sleeve resection in our institution. Data analysed were; length of chest tube drainage in days, length of hospital stay, complications, morbidity and hospital mortality. Results In 178 patients, an anatomical bronchoplastic resection was performed. Preoperative chemotherapy in N2-disease (n =42 was given in 30 patients and radiochemotherapy in 11 patients. The length of the operation was between 94 min-493 min (average 143 min. Chest tubes were removed on average after 5 days. Patients were discharged after 10 days. R0-resection was possible in 90%. The overall complication rate was 27% (11/41. The rate of bronchial anastomotic leakage was 9.7%(4/41. Two patients with postoperative respiratory insufficiency and mechanical ventilation, 1 patient with technical failure required early correction of the suture and one patient with a necrosis of the anastomosis. 30-day hospital mortality rate was 2.4% (1/41. Conclusion Sleeve resection after neoadjuvant therapy has a higher local morbidity (anastomotic insufficiency 9.7% vs 2.8%. This may be explained by the quality of the surrounding tissue after neoadjuvant therapy, which compromises healing of the anastomosis. However, the results are comparable to those without induction therapy interms of radicality, and 30-d mortality rate (P >0.05. We therefore believe that sleeve resection after

  18. Morbidity and mortality after neoadjuvant therapy and sleeve lobectomyin N2-disease

    Institute of Scientific and Technical Information of China (English)

    Corinna LUDWIG; Walburga ENGEL-RIEDEL; Erich STOELBEN

    2008-01-01

    Background and objective Sleeve resections were introduced to preserve lung function in patients with limited pulmonary reserve. Increasing experience with sleeve resection has reduced the rate of pneumonectomy below 10%. The aim of the study was to assess the outcome after neoadjuvant chemo- or chemoradiotherapy and sleeve resection in patients with N2 non-small cell lung cancer. Methods Retrospective analysis of 41 patient records between 01.01.2005 and 31.12.2007 underwent induction therapy in N2-disease followed by tracheobronchial sleeve resection.These patients were compared to the overall results after sleeve resection in our institution. Data analysed were; length of chest tube drainage in days, length of hospital stay, complications, morbidity and hospital mortality. Results In 178 patients, an anatomical bronchoplastic resection was performed. Preoperative chemotherapy in N2-disease (n=42) was given in 30 patients and radiochemotherapy in 11 patients. The length of the operation was between 94 min-493 rain (average 143 min). Chest tubes were removed on average after 5 days. Patients were discharged after 10 days. RO-resection was possible in 90%. The overall complication rate was 27% (11/41). The rate of bronchial anastovaotic leakage was 9.7% (4/41). Two patients with postoperative respiratory, insufficiency and mechanical ventilation, 1 patient with technical failure required early correction of the suture and .ne patient with a necrosis of the anastomosis. 30-day hospital mortality rate was 2.4% (1/41). Conclusion Sleeve resection after neoadjuvant therapy has a higher local morbidity (anastomotic insufficiency 9.7% vs 2.8%). This may be explained by the quality of the surrounding tissue after neoadjuvant therapy,which compromises healing of the anastomosis. However, the results are comparable to those without induction therapy in terms of radicality, and 30-d mortality rate (P>O.05). We therefore believe that sleeve resection after neoadjuvant therapy

  19. A study by upper digestive tract scintigraphy of cases with recurrent pneumonia after gastrectomy

    International Nuclear Information System (INIS)

    Five patients with recurrent pneumonia after gastrectomy were studied by upper digestive tract scintigraphy. Severe gastroesophageal reflux was noted in three of the five patients in the supine position. In the other two patients, the same kind of reflux was easily induced by changing position. Esophageal dysfunction was suspected in four patients. The frequency of pneumonia decreased after we instructed the patients how to avoid reflux. We therefore diagnosed it as the chronic aspiration pneumonia. We concluded that upper digestive tract scintigraphy is useful for evaluating gastroesophageal reflux and esophageal function in patients after gastrectomy. (author)

  20. Prognostic impact of metastatic lymph node ratio on gastric cancer after curative distal gastrectomy

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To investigate the prognostic impact of metastatic lymph node ratio(rN) on gastric cancer after curative distal gastrectomy.METHODS:A total of 634 gastric cancer patients who underwent curative resection(R0) of lymph nodes at distal gastrectomy in 1995-2004.Correlations between positive nodes and retrieved nodes,between rN and retrieved nodes,and between rN and negative lymph node(LN) count were analyzed respectively.Prognostic factors were identif ied by univariate and multivariate analyses.Staging acc...

  1. Totally laparoscopic gastrectomy for early gastric cancer accompanied by huge hiatal hernia: A case report.

    Science.gov (United States)

    Hagiwara, Chie; Yajima, Kazuhito; Iwasaki, Yoshiaki; Oohinata, Ryouki; Yuu, Ken; Ishiyama, Satoshi; Amaki, Misato; Nakano, Daisuke; Yamaguchi, Tatsuro; Matsumoto, Hiroshi; Takahashi, Keiichi

    2016-02-01

    We herein present a case in which we used a totally laparoscopic approach for early gastric cancer accompanied by a huge hiatal hernia. An 80-year-old Japanese woman was referred with a chief complaint of dysphagia. A clinical diagnosis of early gastric cancer, T1b (SM) N0M0, stage IA, accompanied by hiatal hernia, was made. Distal gastrectomy with D1 plus lymphadenectomy was carried out. After the gastrectomy, the hernial sac was excised and the hernial orifice was closed. Reconstruction using the Roux-en-Y method was selected. The postoperative course was uneventful and she was discharged on postoperative day 10.

  2. Risk factors for hospital readmission after radical gastrectomy for gastric cancer:a prospective study

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Objective:hTe purpose of this prospective study was to determine risk factors for readmission within 30 days of discharge after gastrectomy for patients with gastric cancer.Methods: We conducted a prospective study of patients undergoing radical gastrectomy for gastric cancer from October 2013 to November 2014 in our institution. hTe incidence, cause and risk factors for 30-day readmission were determined.Results:A total of 376 patients were included in our analysis without loss in follow-up. hTe 30-day readmission rate after radical gastrectomy for gastric cancer was 7.2% (27 of 376). The most common cause for readmission included gastrointestinal complications and postoperative infections. On the basis of multivariate logistic regression analysis, preoperative nutritional risk screening 2002 score ≥ 3 was an independent risk factor for 30-day readmission. Conclusion:Readmission within 30 days of discharge atfer radical gastrectomy for gastric cancer is common. Patients with nutritional risk preoperatively are at high risk for 30-day readmission.

  3. Theoretical Vibration Analysis Regarding Excitation due to Elliptical Shaft Journals in Sleeve Bearings of Electrical Motors

    Directory of Open Access Journals (Sweden)

    Ulrich Werner

    2012-01-01

    Full Text Available This paper shows a theoretical vibration analysis regarding excitation due to elliptical shaft journals in sleeve bearings of electrical motors, based on a simplified rotordynamic model. It is shown that elliptical shaft journals lead to kinematic constraints regarding the movement of the shaft journals on the oil film of the sleeve bearings and therefore to an excitation of the rotordynamic system. The solution of the linear differential equation system leads to the mathematical description of the movement of the rotor mass, the shaft journals, and the sleeve bearing housings. Additionally the relative movements between the shaft journals and the bearing housings are deduced, as well as the bearing housing vibration velocities. The presented simplified rotordynamic model can also be applied to rotating machines, other than electrical machines. In this case, only the electromagnetic spring value cm has to be put to zero.

  4. Robotic-assisted thoracoscopic sleeve lobectomy for locally advanced lung cancer

    Science.gov (United States)

    Lin, Mong-Wei; Kuo, Shuenn-Wen; Yang, Shun-Mao

    2016-01-01

    Background The Da Vinci robotic system has been used to enhance the surgeon’s visualization and agility in lung cancer surgery, and thus facilitate refined dissection, knot tying and suturing. However, only a few case reports exist on performing a sleeve lobectomy with a robotic-assisted thoracoscopic surgery (RATS) technique. Here we describe our early experience performing RATS sleeve lobectomies. To our knowledge, this is the first study reporting a series of RATS sleeve lobectomies. Methods The six consecutive NSCLC patients who underwent a RATS sleeve lobectomy between November 2013 and July 2015 at the National Taiwan University Hospital were enrolled in this study. The lobectomies were all performed by the same surgeon using a three-arm robotic system with an additional utility incision made for assistance and specimen retrieval. Results Five patients were diagnosed with squamous cell carcinoma, while the sixth was diagnosed with a carcinoid tumor. The mean operation time was 436.7 [255–745] minutes. The mean postoperative intensive care unit (ICU) stay and hospital stay were 3.7 [1–11] and 11.3 [3–26] days, respectively. Two (33.3%; 2/6) morbidities were noted, including one pneumonia and one anastomosis stricture. There were no cases of mortality or of conversion to thoracotomy. Conclusions Our experience performing a RATS sleeve lobectomy in the six patients demonstrated the feasibility of RATS in complex lung cancer surgeries. The three-dimensional vision and articulated joint instruments made robotic-assisted bronchial anastomosis easier under the endoscopic setting. Our experience suggests that RATS offers specific advantages with regard to accuracy and safety when performing sleeve lobectomies.

  5. Robotic-assisted thoracoscopic sleeve lobectomy for locally advanced lung cancer

    Science.gov (United States)

    Lin, Mong-Wei; Kuo, Shuenn-Wen; Yang, Shun-Mao

    2016-01-01

    Background The Da Vinci robotic system has been used to enhance the surgeon’s visualization and agility in lung cancer surgery, and thus facilitate refined dissection, knot tying and suturing. However, only a few case reports exist on performing a sleeve lobectomy with a robotic-assisted thoracoscopic surgery (RATS) technique. Here we describe our early experience performing RATS sleeve lobectomies. To our knowledge, this is the first study reporting a series of RATS sleeve lobectomies. Methods The six consecutive NSCLC patients who underwent a RATS sleeve lobectomy between November 2013 and July 2015 at the National Taiwan University Hospital were enrolled in this study. The lobectomies were all performed by the same surgeon using a three-arm robotic system with an additional utility incision made for assistance and specimen retrieval. Results Five patients were diagnosed with squamous cell carcinoma, while the sixth was diagnosed with a carcinoid tumor. The mean operation time was 436.7 [255–745] minutes. The mean postoperative intensive care unit (ICU) stay and hospital stay were 3.7 [1–11] and 11.3 [3–26] days, respectively. Two (33.3%; 2/6) morbidities were noted, including one pneumonia and one anastomosis stricture. There were no cases of mortality or of conversion to thoracotomy. Conclusions Our experience performing a RATS sleeve lobectomy in the six patients demonstrated the feasibility of RATS in complex lung cancer surgeries. The three-dimensional vision and articulated joint instruments made robotic-assisted bronchial anastomosis easier under the endoscopic setting. Our experience suggests that RATS offers specific advantages with regard to accuracy and safety when performing sleeve lobectomies. PMID:27499965

  6. Remote welding device for sleeve in a tube of nuclear power plant steam generator

    International Nuclear Information System (INIS)

    For welding an inner sleeve round the defective area of a steam generator tube, an optical fiber carries a YAG laser beam to an optical cell which focuses the beam onto the sleeve, the optical cell turning about the fiber which can slide axially. The welding beam is focused using a control beam from a helium-neon laser which is also injected into the optical fiber and its return intensity measured and then optimized by displacing the optical fiber axially with respect to the optical cell

  7. Process and device for extracting a blocking sleeve of a PWR assembly with removable guide tubes

    International Nuclear Information System (INIS)

    An annular hydraulic actuator is used to move the fingers of a damp to grip the sleeve. The body of the actuator is attached to a long rod. A piston moving in the direction of the rods axis has a tronconical part shaped to correspond to the external surface of the upper part of the damp's fingers. The piston moves in a way by the action of a pressurized fluid feeding its chamber and in the opposite way by springs. An assembly of these devices can be used to extract many sleeves simultaneously

  8. Effects of total gastrectomy on plasma silicon and amino acid concentrations in men.

    Science.gov (United States)

    Tatara, Marcin R; Krupski, Witold; Szpetnar, Maria; Dąbrowski, Andrzej; Bury, Paweł; Szabelska, Anna; Charuta, Anna; Boguszewska-Czubara, Anna; Maciejewski, Ryszard; Wallner, Grzegorz

    2015-12-01

    The aim of the study was to determine one-year effects of total gastrectomy on plasma silicon and free amino acid concentrations in patients and evaluate changes of volumetric bone mineral density (vBMD) in lumbar spine. Eight patients were enrolled to the control (CTR) group. Six patients subjected to total gastrectomy (GX group) were included to the experimental group. vBMD in trabecular and cortical bone was measured in lumbar vertebrae at baseline (before surgery) and one year later using quantitative computed tomography. Plasma concentrations of silicon and free amino acids were determined at baseline and one year later using photometric method and ion-exchange chromatography. Body weights within CTR and GX groups were not different after one-year follow-up when compared to the baseline values (P > 0.05). An average annual decrease of vBMD in the trabecular bone in the gastrectomized patients reached 15.0% in lumbar spine and was significantly different in comparison to the percentage changes observed in CTR group (P = 0.02). One-year percentage change of vBMD in the cortical bone in L1 and L2 has shown significantly decreased values by 10.5 and 9.1% in the GX group when compared to the percentage change observed in the controls (P silicon was significantly lowered by 26.7% one year after the total gastrectomy when compared to the baseline value (P = 0.009). Total gastrectomy in patients has induced severe osteoporotic changes in lumbar spine within one-year period. The observed osteoporotic changes were associated with decreased plasma concentration of silicon indicating importance of exocrine and endocrine functions of stomach for silicon homeostasis maintenance. Gastrectomy-induced bone loss was not related to decreased amino acid concentration in plasma obtained from overnight fasted patients.

  9. Gastric cancer surgery in cirrhotic patients: Result of gastrectomy with D2 lymph node dissection

    Institute of Scientific and Technical Information of China (English)

    Jun Ho Lee; Junuk Kim; Jae Ho Cheong; Woo Jin Hyung; Seung Ho Choi; Sung Hoon Noh

    2005-01-01

    AIM: To explore the feasibility of performing gastrectomy with D2 lymphadenectomy in gastric cancer patients with liver cirrhosis.METHODS: A total of 7 178 patients were admitted with a diagnosis of liver cirrhosis from January 1993 to December 2003. We reviewed the records of 142 patients who were diagnosed with liver cirrhosis and gastric adenocarcinoma during the same period. Gastrectomy with D2 lymph node dissection for carcinoma of the stomach was performed in 94 patients with histologically proven hepatic cirrhosis.RESULTS: All but 12 patients were classified as Child's class A. Only 35 patients (37.2%) were diagnosed with cirrhosis before operation. Seventy-three patients underwent a subtotal gastrectomy (77.7%) and 21 patients (22.3%)underwent a total gastrectomy, each with D2 or more lymph node dissection. Two patients (3.8%) who had prophylactic intra-operative drain placement, died of postoperative complications from hepatorenal failure with intractable ascites. Thirty-seven patients (39.4%) experienced postoperative complications. The extent of gastric resection did not influence the morbidity whereas serum aspartate aminotransferase level (P = 0.011) and transfusion did (P= 0.008). The most common postoperative complication was ascites (13.9%) followed by wound infection (10.6%).CONCLUSION: We concluded that the presence of compensated cirrhosis, i.e. Child class A, is not a contraindication against gastrectomy with D2 or more lymph node dissection, when curative resection for gastric cancer is possible. Hepatic reserve and meticulous hemostasis are the likely determinants of operative prognosis.

  10. Development and design of dual-band, multi-function remote sensing antennas

    Science.gov (United States)

    Creticos, Justin P.

    This dissertation details the theoretical development, design, fabrication, and testing of two remote sensing antennas. The antennas operate in Ku and Ka bands and must support multiple beams, polarizations, and frequencies with a single aperture. The first antenna, developed for NASA's High-Altitude Imaging Wind and Rain Airborne Profiler, is a single, offset-fed reflector that supports dual-band beams incident at 30° and 40° off-nadir. The antenna uses two compact, dual-band feeds moved away from the reflector's focal point to meet the dual beam requirement. The radar is to be flown on the Global Hawk Uninhabited Aerial Vehicle which has a small payload bay requiring the feeds to be both rugged and compact. The second antenna, developed for Remote Sensing Solutions' Dual-Wavelength Precipitation Radar, is a dual-offset Gregorian reflector. The antenna supports a single, dual-band, beam with dual-polarization at each band. Additionally, the antenna has high polarization purity and matched half power beamwidths at Ku and Ka bands. The strict requirements of the antenna are met by precisely controlling feed radiation characteristics. The two antennas necessitated several advances in feed design. A foam sleeve is demonstrated as an effective method to reduce the beamwidth of a tapered dielectric rod antenna. The foam sleeve is an attractive design because it allows dual-band feeds where a corrugated horn is used to control radiation at lower frequencies and the sleeve corrected rod is used to control the upper band. By judiciously choosing sleeve material, independent control of the radiation pattern and phase center at each band is achieved allowing higher performance feeds. This dissertation also focuses on new developments in the backend design of feeds. Specifically, the use of tuning arms in the feed backend and double ridged waveguide to couple the signal into the feed allow more compact designs with greater bandwidth.

  11. DEVISING THE UP-TO-DATE METHOD PATTERN MAKING OF FEMALE APPAREL WITH RAGLAN SLEEVE

    Institute of Scientific and Technical Information of China (English)

    Li Yue; V.E. Kuzmichev; E. Sablina

    2004-01-01

    This article aimed to find a new way to transform the graphic image (drawing, photos, etc) to the pattern parameters of female apparel with raglan sleeve. The correlation and regressive analysis were used to the data in order to find the existing laws between them. The practical examinations demonstrated the good predictability of equations established.

  12. Rotor losses in laminated magnets and an anisotropic carbon fiber sleeve

    NARCIS (Netherlands)

    Van der Geest, M.; Wolmarans, J.J.; Polinder, H.; Ferreira, J.A.; Zeilstra, D.

    2012-01-01

    High speed fault tolerant permanent magnet machines have strong asynchronous airgap harmonics, making them susceptible to rotor eddy-current losses. These losses can be reduced by using novel high resistivity materials like plastic bonded magnets and carbon fiber reinforced retaining sleeves. This p

  13. The Single Needle Lockstitch Machine. [Constructing and Setting Sleeves.] Module 7.

    Science.gov (United States)

    South Carolina State Dept. of Education, Columbia. Office of Vocational Education.

    This module on constructing and setting sleeves, one in a series on the single needle lockstitch sewing machine for student self-study, contains two sections. Each section includes the following parts: an introduction, directions, an objective, learning activities, student information, student self-check, check-out activities, and an instructor's…

  14. Endoscopic sleeve gastroplasty (the Apollo method: a new approach to obesity management

    Directory of Open Access Journals (Sweden)

    Gontrand López-Nava-Breviere

    2016-04-01

    Full Text Available Background: Many obese patients cannot lose weight or reject conventional obesity management. Endoscopic sleeve gastroplasty (the Apollo method is a pioneering coadjuvant, interventionist technique for the integral management of obesity. Objectives: The goals of this study were to report safety and efficacy results obtained at 6 months in patients undergoing endoscopic sleeve gastroplasty. Material and methods: A prospective study was performed in 55 patients (13 males, 42 females who were subjected to the Apollo technique; mean age was 43.5 years (range 25-60 and mean BMI was 37.7 kg/m² (range 30-48. All received multidisciplinary follow-up for weight loss. Weight changes and presence of complications were assessed. Through the endoscope a triangular pattern suture is performed consisting of approximately 3-6 transmural (mucosa to serosa stitches, using a cinch device to bring them nearer and form a plication. Results: A total of 6-8 plications are used to provide a tubular or sleeve-shaped restriction to the gastric cavity. No major complications developed and patients were discharged at 24 hours following the procedure. Endoscopic and radiographic follow-up at 6 months post-procedure showed a well preserved tubular form to the stomach. After 6 months patients had lost 18.9 kg and 55.3% of excess weight. Conclusions: Endoscopic sleeve gastroplasty, together with dietary and psycho-behavioral changes, is a safe, effective technique in the coadjuvant management of obese patients.

  15. Concept for sleeve induction motor with 1-msec mechanical time constant

    Science.gov (United States)

    Wiegand, D. E.

    1968-01-01

    Conductive sleeve induction motor having a 1-msec mechanical time constant is used with solid-state devices to control all-electric servo power systems. The servomotor rotor inertia is small compared to the maximum force rating of the servo motion, permitting high no-load acceleration.

  16. Study of insulator sleeve and ceiling effect in Mather type plasma focus

    International Nuclear Information System (INIS)

    Neutron emission from a small Mather-type Plasma Focus facility is studied. Specifically, the effects of insulator sleeve length and a ''ceiling'' introduced in front of the central electrode on the neutron yield and on the fluence anisotropy are investigated. 3 refs, 5 figs

  17. Effect of insulator sleeve length on neutron emission in a plasma focus

    International Nuclear Information System (INIS)

    Neutron emission from a small Mather-type plasma focus facility operated by a single 32 μF, 15 kV capacitor is studied. Specifically, the effects of insulator sleeve length and a ''ceiling'' introduced in front of the central electrode on the neutron yield and on the fluence anisotropy are investigated. (orig.)

  18. Duodenal-jejunal bypass sleeve - a potential alternative to bariatric surgery?

    DEFF Research Database (Denmark)

    Rohde, Ulrich; Gylvin, Silas; Vilmann, Peter;

    2014-01-01

    Overweight and obesity are risk factors for several co-morbidities reducing life expectancy. Conservative treatment of obesity is generally ineffective in the long-term. Bariatric surgery has proven effective, but is associated with potential complications. Duodenal-jejunal bypass sleeve is a novel...

  19. Effects of total gastrectomy on plasma silicon and amino acid concentrations in men.

    Science.gov (United States)

    Tatara, Marcin R; Krupski, Witold; Szpetnar, Maria; Dąbrowski, Andrzej; Bury, Paweł; Szabelska, Anna; Charuta, Anna; Boguszewska-Czubara, Anna; Maciejewski, Ryszard; Wallner, Grzegorz

    2015-12-01

    The aim of the study was to determine one-year effects of total gastrectomy on plasma silicon and free amino acid concentrations in patients and evaluate changes of volumetric bone mineral density (vBMD) in lumbar spine. Eight patients were enrolled to the control (CTR) group. Six patients subjected to total gastrectomy (GX group) were included to the experimental group. vBMD in trabecular and cortical bone was measured in lumbar vertebrae at baseline (before surgery) and one year later using quantitative computed tomography. Plasma concentrations of silicon and free amino acids were determined at baseline and one year later using photometric method and ion-exchange chromatography. Body weights within CTR and GX groups were not different after one-year follow-up when compared to the baseline values (P > 0.05). An average annual decrease of vBMD in the trabecular bone in the gastrectomized patients reached 15.0% in lumbar spine and was significantly different in comparison to the percentage changes observed in CTR group (P = 0.02). One-year percentage change of vBMD in the cortical bone in L1 and L2 has shown significantly decreased values by 10.5 and 9.1% in the GX group when compared to the percentage change observed in the controls (P < 0.05). Plasma concentration of adipic acid was significantly higher by 101.6% one year after total gastrectomy procedure in the patients when compared to the baseline value (P = 0.01). Plasma concentration of silicon was significantly lowered by 26.7% one year after the total gastrectomy when compared to the baseline value (P = 0.009). Total gastrectomy in patients has induced severe osteoporotic changes in lumbar spine within one-year period. The observed osteoporotic changes were associated with decreased plasma concentration of silicon indicating importance of exocrine and endocrine functions of stomach for silicon homeostasis maintenance. Gastrectomy-induced bone loss was not related to decreased amino acid

  20. D2 dissection in laparoscopic and open gastrectomy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Ming Cui; Jia-Di Xing; Wei Yang; Yi-Yuan Ma; Zhen-Dan Yao; Nan Zhang; Xiang-Qian Su

    2012-01-01

    AIM:To evaluate the radicalness and safety of laparoscopic D2 dissection for gastric cancer.METHODS:Clinicopathological data from 209 patients with gastric cancer,who underwent radical gastrectomy with D2 dissection between January 2007 and February 2011,were analyzed retrospectively.Among these patients,131 patients underwent laparoscopyassisted gastrectomy (LAG) and 78 underwent open gastrectomy (OG).The parameters analyzed included operative time,blood loss,blood transfusion,morbidity,mortality,the number of harvested lymph nodes (HLNs),and pathological stage.RESULTS:There were no significant differences in sex,age,types of radical resection [radical proximal gastrectomy (PG + D2),radical distal gastrectomy (DG + D2) and radical total gastrectomy (TG + D2)],and stages between the LAG and OG groups (P > 0.05).Among the two groups,127 cases (96.9%) and 76 cases (97.4%) had 15 or more HLNs,respectively.The average number of HLNs was 26.1 ± 11.4 in the LAG group and 24.2 ± 9.3 in the OG group (P =0.233).In the same type of radical resection,there were no significant differences in the number of HLNs between the two groups (PG + D2:21.7 ± 7.5 vs 22.4 4-9.3;DG + D2:25.7 ± 11.0 vs 22.3 ± 7.9; TG + D2:30.9 ± 13.4 vs 29.3 ± 10.4; P > 0.05 for all comparisons).Tumor free margins were obtained in all cases.Compared with OG group,the LAG group had significantly less blood loss,but a longer operation time (P < 0.001).The morbidity of the LAG group was 9.9%,which was not significantly different from the OG group (7.7%) (P=0.587).The mortality was zero in both groups.CONCLUSION:Laparoscopic D2 dissection is equivalent to OG in the number of HLNs,regardless of tumor location.Thus,this procedure can achieve the same radicalness as OG.

  1. Surgical Outcomes and Local Recurrence Following Total or Subtotal Gastrectomy for Early Adenocarcinoma of Antrum

    Institute of Scientific and Technical Information of China (English)

    Mehrdad Moghimi; Seyed Ali Marashi; Taghi Salehian; Habibollah Peirovi; Faezeh Sodagari

    2008-01-01

    Objective:The choice between total gastrectomy(TG)and subtotal gastrectomy(STG)for early adenocarcinoma of the lower third of the stomach is still a matter of debate and controversy amongst surgeons.The aim of this study was to compare the surgical outcomes,quality of life(QoL),and local recurrence rates as well as other results of curative resection of early distal adenocarcinoma of the stomach using TG or STG performed in Iran. Methods:Hospital records of 66 patients with early distal adenocarcinoma of stomach that underwent even total or subtotal gastrectomy with perigastric(D2)lymphadenectomy between October 2001 and February 2006 in Taleghani Hospital,Iran were reviewed retrospectively.Demographic data as well as clinicopathological factors including number of involved lymph nodes,tumor grading,depth of invation,tumor size,and tumor type were recorded.Post-operative outcomes including mortality and morbidity,tumor recurrence and quality of life were assessed.Univariate analyses using Fisher's exact test,the Student t-test,and the Pearson X2 test were used. Results:Local recurrence of tumor was found in 8(23%)TG group patients and in 19(61%)patients of STG group.the Pearson X2 test showed a significant higher recurrence rate in STG(P value=0.002,Relative Risk=2.68,Confidence Interval:1.37-5.24).The mean time interval between gastrectomy and tumor recurrence was not different between TG and STG.(19.75±5.1 vs.18.0±7.8 respectively;P value=0.507)Tumor size>5 cm(P value=0.004),diffuse type(P value=0.034),poor differentiation(P value=0.000)and serosal invasion(P value=0.012)were found to be significantly related to tumor recurrence in patients undergone gastrectomy.In none of the QoL measures a significant difference was found between TG and STG. Conclusion:Our results show that subtotal and total gastrectomy methods with perigastric lymphadenectomy have a similar postoperative complication rate and surgical outcomes as well as patient's QoL but STG was

  2. Percutaneous Trans-hepatic Obliteration for Bleeding Esophagojejunal Varices After Total Gastrectomy and Esophagojejunostomy

    International Nuclear Information System (INIS)

    A 72-year-old man who had undergone a total gastrectomy with a Roux-en-Y esophagojejunostomy for gastric cancer 6 years earlier presented to our hospital with massive hematemesis and melena. Endoscopic examination indicated esophageal varices with cherry-red spots and hemorrhage arising from beyond the anastomosis. Abdominal contrast-enhanced computed tomography and angiography revealed a dilated vein in the elevated jejunal limb supplying the varices. Percutaneous trans-hepatic obliteration (PTO) of the varices through the jejunal vein was performed using microcoils, ethanolamine oleate, and gelatin sponge cubes. Ten days after the procedure, endoscopic examination revealed reduction and thrombosis of the varices. We consider PTO to be an effective alternative method for treating ruptured esophagojejunal varices after total gastrectomy

  3. The Meta-analysis:laparoscopy versus open distal gastrectomy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Objective:In this study, using meta-analysis, we compared the LADG with open distal gastrectomy (ODG) in the treatment of patients with advanced gastric cancer.Methods: The RevMan 5.0 software was used for the meta-analysis.Results:The meta-analysis indicated that in comparison with patients who underwent open distal gastrectomy, patients who were treated with LADG had shorter hospital stay, less analgesic requirements and blood loss, less overall complications, including intestinal obstruction, earlier time to liquid ingestion, and less wound infections. Nevertheless, there is no significant difference between LADG and ODG in anastomotic hemorrhage, anastomotic stenosis, duodenal stump leakage, tumor margin, lymph node dissection, mortality, pneumonia or reoperation. And in case of long-term survivals, both OS (overall-survival) and DFS (disease-free survival) showed no significant difference between LADG and ODG.Conclusion:LADG is feasible for the treatment of advanced gastric cancer, and provides several advantages.

  4. Hiatal hernia following total gastrectomy with Roux-en-Y reconstruction.

    Science.gov (United States)

    Murata, S; Yamazaki, M; Kosugi, C; Hirano, A; Yoshimura, Y; Shiragami, R; Suzuki, M; Shuto, K; Koda, K

    2014-01-01

    Hiatal hernias after total gastrectomy for advanced gastric cancer are very rare. We review a case of a 44-year-old male who presented with dyspnea and chest pain 2 days after total gastrectomy, lower esophagectomy, and splenectomy with retrocolic Roux-en-Y reconstruction approached by a left thoracoabdominal incision for gastric cancer at the cardia. Plain and cross-sectional imaging identified a large hiatal hernia protruding into the right thorax containing left-sided transverse colon and small intestine. Our patient underwent a laparotomy, and after hernia reduction the hiatal defect was repaired by direct suturing. He experienced anastomotic leakage and right pyothorax, but recovered. The potential cause is discussed here and the published literature on this rare complication is reviewed briefly.

  5. Anemia after gastrectomy for early gastric cancer:Long-term follow-up observational study

    Institute of Scientific and Technical Information of China (English)

    Chul-Hyun Lim; Sang Woo Kim; Won Chul Kim; Jin Soo Kim; Yu Kyung Cho; Jae Myung Park; In Seok Lee

    2012-01-01

    AIM:To identify the incidence and etiology of anemia after gastrectomy in patients with long-term follow-up after gastrectomy for early gastric cancer.METHODS:The medical records of those patients with early gastric adenocarcinoma who underwent curative gastrectomy between January 2006 and October 2007 were reviewed.Patients with anemia in the preoperative workup,cancer recurrence,undergoing systemic chemotherapy,with other medical conditions that can cause anemia,or treated during follow up with red cell transfusions or supplements for anemia were excluded.Anemia was defined by World Health Organization criteria (Hb < 12 g/dL in women and <13 g/dL in men).Iron deficiency was defined as serum ferritin < 20 μg/dL.Vitamin B12 deficiency was defined as serum vitamin B12 < 200 pg/mL.Iron deficiency anemia was defined as anemia with concomitant iron deficiency.Anemia from vitamin B12 deficiency was defined as megaloblastic anemia (mean cell volume >100 fL) with vitamin B12 deficiency.The profile of anemia over 48 mo of follow-up was analyzed.RESULTS:One hundred sixty-one patients with gastrectomy for early gastric cancer were analyzed.The incidence of anemia was 24.5% at 3 mo after surgery and increased up to 37.1% at 48 mo after surgery.The incidence of iron deficiency anemia increased during the follow up and became the major cause of anemia at 48 mo after surgery.Anemia of chronic disease and megaloblastic anemia were uncommon.The incidence of anemia in female patients was significantly higher than in male patients at 12 (40.0% vs 22.0%,P =0.033),24 (45.0% vs 25.0%,P =0.023),36 (55.0%vs 28.0%,P =0.004),and 48 mo (52.0% vs 31.0%,P =0.022) after surgery.Patients with total gastrectomy showed significantly higher incidence of anemia than patients with subtotal gastrectomy at 48 mo after surgery (60.7% vs 31.3%,P =0.008).The incidence of iron deficiency was significantly higher in female patients than in male patients at 6 (35.4% vs

  6. Anticorrosive field joint coating qualification, heat shrinkable sleeve; Qualificacao de revestimento anticorrosivo para juntas de campo, mantas termocontrateis

    Energy Technology Data Exchange (ETDEWEB)

    Cabral, Glaucia B.; Koebsch, Andre; Castinheiras Junior, Wilson [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2005-07-01

    The main objective of this job is to present the quality requirements fixed by PETROBRAS for anticorrosive field joint coating for buried pipelines, industrially coated with PE-3L. It describes the used system - polyethylene based heat shrinkable sleeve - comparing with the existent on the pipeline. So, it exposes the suppliers' qualification stages, which include test carried out for the materials, for the sleeve set and for the coating after its application on the joint field. Finally, it shows that the experience, which has been gotten in the qualification, consolidated the quality control systematic that have been carry out during the sleeves acquisition and application at the pipeline construction. (author)

  7. Anterograde jejunojejunal intussusception resulted in acute efferent loop syndrome after subtotal gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Jung; Myun; Kwak; Jin; Kim; Sung; Ock; Suh

    2010-01-01

    Postoperative intussusception is an unusual clinical entity in adults,and is rarely encountered as a complication following gastric surgery.The most common type after gastric surgery is retrograde jejunogastric intussusception,and jejunojejunal intussusception has been rarely reported.We report a case of anterograde jejunojejunal intussusception after radical subtotal gastrectomy with Billroth Ⅱ anastomosis in a 38-year-old Korean woman with early gastric cancer,and include a review of the literature on thi...

  8. Total laparoscopic subtotal gastrectomy with transvaginal specimen extraction is feasible in advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Fatih Sumer

    2015-01-01

    Conclusions: Transvaginal specimen extraction after laparoscopic gastric resection for advanced gastric cancer is a feasible procedure. It is offered to selected patients and of course only to female patients. Natural orifice surgery may provide faster recovery and decrease the wound related complications which may cause a delay on postoperative adjuvant chemo–radio therapies. We have presented, as far as we know, the first human case of a transvaginal extraction of an advanced gastric cancer after laparoscopic gastrectomy.

  9. Traumatic Neuroma around the Celiac Trunk after Gastrectomy Mimicking a Nodal Metastasis: A Case Report

    OpenAIRE

    Kwon, Jung Hyeok; Ryu, Seung Wan; Kang, Yu Na

    2007-01-01

    Traumatic neuroma is a well-known disorder that occurs after trauma or surgery involving the peripheral nerve and develops from a nonneoplastic proliferation of the proximal end of a severed, partially transected, or injured nerve. We present a case of traumatic neuroma around the celiac trunk after gastrectomy in a 56-year-old man, which was confirmed by pathology. CT demonstrated the presence of a lobulated, homogeneous, hypoattenuating mass around the celiac trunk, mimicking a nodal metast...

  10. Gastroduodenal ulcer treated by pylorus and pyloric vagus-preser-ving gastrectomy

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    AIM To evaluate the curative effect of pylorus and pyloric vagus-preserving gastrectomy (PPVPG) on peptic ulcer.METHODS Treating 132 cases of GU and DU with PPVPG, and comparative studies made with 24 cases treated with Billroth Ⅰ (BⅠ) and 20 cases with Billroth Ⅱ (BⅡ); advantages and shortcomings evaluated.RESULTS Not a single death after PPVPG. No recurrence of the disorder in the subsequent follow-up for an average of 6.5 years. Curative effect (visik Ⅰ & Ⅱ) 97.7%. Acidity reduction similar to that found in BⅠ and BⅡ, but 97.7% of the BⅠ and all BⅡ cases having more than second degree intestinal fluid reflux, in contrast to 7.1% in PPVPG cases. Dumping syndrome occurred in the BⅠ and BⅡ cases, none in PPVPG cases. With regard to gastric emptying, food digestion, absorption, body weight and life quality, PPVPG proved to be superior to Billroth procedure.CONCLUSION PPVPG has the advantages of conventional Billroth gastrectomy in reducing acid, removing ulcer focus, and at the same time preserves the pylorus and pyloric vagus for maintaining the normal gastric physiological function. Dumping syndrome, intestinal fluid reflux and other complications of conventional gastrectomy may be avoided.

  11. Complications after radical gastrectomy following FOLFOX7 neoadjuvant chemotherapy for gastric cancer

    Directory of Open Access Journals (Sweden)

    Ren Hui

    2011-09-01

    Full Text Available Abstract Background This study assessed the postoperative morbidity and mortality occurring in the first 30 days after radical gastrectomy by comparing gastric cancer patients who did or did not receive the FOLFOX7 regimen of neoadjuvant chemotherapy. Methods We completed a retrospective analysis of 377 patients after their radical gastrectomies were performed in our department between 2005 and 2009. Two groups of patients were studied: the SURG group received surgical treatment immediately after diagnosis; the NACT underwent surgery after 2-6 cycles of neoadjuvant chemotherapy. Results There were 267 patients in the SURG group and 110 patients in the NACT group. The NACT group had more proximal tumours (P = 0.000, more total/proximal gastrectomies (P = 0.000 and longer operative time (P = 0.005 than the SURG group. Morbidity was 10.0% in the NACT patients and 17.2% in the SURG patients (P = 0.075. There were two cases of postoperative death, both in the SURG group (P = 1.000. No changes in complications or mortality rate were observed between the SURG and NACT groups. Conclusion The FOLFOX7 neoadjuvant chemotherapy is not associated with increased postoperative morbidity, indicating that the FOLFOX7 neoadjuvant chemotherapy is a safe choice for the treatment of local advanced gastric cancer.

  12. The Application of FJI and Its Comparison with Different Alimentary Reconstructions after Total Gastrectomy for Cances

    Institute of Scientific and Technical Information of China (English)

    HAOXishan; LIQiang; 等

    2002-01-01

    Objective To investigate the optimum reconstruction after total gastrectomy for malignant disease,especially the necessity of gastric substitute and duodenal passage.Methods Among the 459 total gastrectomy cases,6 kinds of reconstructions had been used,including Braun,modified Braun I(mBraun I),modified Braun Ⅱ(mBraun Ⅱ),Roux-en-Y,“P jejunal interposition(PJI)and functional jejunal interposition(FJI).Postoperative complains,body weight,food intake,serum nutritional paraments,complete blood cout,half-emptying time of the gastric substitute,PNI,Visick index were evaluated one year after r surgery.Results As compared with Braun group,the mBraun I,Ⅱ and Roux-en-Y groups which had some kinds of gastric substitute showed less reflux esophagitis and higher serum total protein(P<0.01).As compared with mBraun I,Ⅱ,Roux-en-Y,PJI and FJI groups which had duodenal passage showed better body weight,higher nutritional paraments and PNI(P<0.05).Conclusion It is essential to construct a gastric substitute and maintain the food chyme flowing through the duodenum after total gastrectomy,and the FJI is a better choice in this study.

  13. Endoscopic Retrograde Cholangiopancreatography Using a Dual-Lumen Endogastroscope for Patients with Billroth II Gastrectomy

    Directory of Open Access Journals (Sweden)

    Wei Yao

    2013-01-01

    Full Text Available Objective. To evaluate the safety and efficacy of a dual-lumen forward-viewing endoscope for ERCP in patients with prior Billroth II gastrectomy. Methods. The records of 46 patients treated with ERCP by a dual-lumen forward-viewing endoscope after Billroth II gastrectomy from 2007 to 2012 were reviewed. Results. The success rate of selective cannulation was 82.6% (38/46. Of the 38 cases with successful selective cannulation, endoscopic sphincterotomy was achieved in 23 cases by placing the needle knife through the 2nd lumen, while endoscopic papillary balloon dilatation was conducted in the other 15 cases. Of the 8 failed cases of selective cannulation, 6 had failed afferent loop intubation, and 3 of these 6 patients had Braun’s anastomosis. The safety and efficacy of catheter-assisted endoscopic sphincterotomy were increased by placing the needle knife through the 2nd lumen without altering the conventional endoscopic sphincterotomy procedure. Conclusions. A dual-lumen forward-viewing endoscope can be safely and effectively used to perform ERCP in patients with a Billroth II gastrectomy, except for patients with additional Braun’s anastomosis.

  14. Effects of vagus nerve preservation and vagotomy on peptide YY and body weight after subtotal gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Hyung Hun Kim; Moo In Park; Sang Ho Lee; Hyun Yong Hwang; Sung Eun Kim; Seun Ja Park; Won Moon

    2012-01-01

    AIM:To investigate the relationship between the function of vagus nerve and peptide YY3-36 and ghrelin levels after subtotal gastrectomy,METHODS:We enrolled a total of 16 patients who underwent subtotal gastrectomy due to gastric cancer.All surgeries were performed by a single skilled surgeon.We measured peptide YY3-36,ghrelin,leptin,insulin,growth hormone levels,and body weight immediately before and one month after surgery.RESULTS:Vagus nerve preservation group showed less body weight loss and less increase of peptide YY3-36 compared with vagotomy group (-5.56 ± 2.24 kg vs -7.85 ± 1.57 kg,P =0.037 and 0.06 ± 0.08 ng/mL vs 0.19±0.12 ng/mL,P =0.021,respectively).Moreover,patients with body weight loss of less than 10% exhibited reduced elevation of peptide YY3-36 level,typically less than 20% [6 (66.7%) vs 0 (0.0%),P =0.011,odd ratio =3.333,95% confidence interval (1.293,8.591)].CONCLUSION:Vagus nerve preservation contributes to the maintenance of body weight after gastrectomy,and this phenomenon may be related to the suppressed activity of peptide YY3-36.

  15. Comparison of peritoneal free gastric cancer cells' detecting rates between laparoscopically assisted and open radical gastrectomy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To compare laparoscopic gastrectomy and conventional surgery on the dissemination and seeding of tumor cells. Methods:Intraoperative peritoneal lavage cytologic examination was performed in 65 patients with gastric cancer, during laparoscopic gastrectomy (n=34) and conventional surgery (n=31). Cytology was examined twice, immediately after opening the peritoneal cavity and just before closing the abdomen. Saline was poured into the peritoneal cavity, and 100 ml fluid was retrieved after irrigation. Laparoscopic instruments were lavaged after surgery with 100 ml saline. Carbon dioxide (CO2) was derived through the trocar side orifice after pneumoperitoneum during laparoscopic gastrectomy and filtered through 100 ml saline. Cytologic examination of the filtrate was performed after the filtration process. Results: The incidence of positive cytology during laparoscopic surgery was 32.26% in the preoperative lavage and 22.58% in the postoperative lavage. The incidence of positive cytology during conventional surgery was 41.18% before lavage and 26.47% after lavage. Only one positive cytology was detected in the CO2 filtrate gas. The incidence of positive cytology in the lavage of the instruments during laparoscopic surgery was 6.45%. Conclusion: During gastric laparoscopic surgery, CO2 pneumoperitoneum does not affect tumor cell dissemination and seeding. In this study, laparoscopic techniques used in gastric cancer surgery were not associated with a higher risk for intraperitoneal dissemination of cancer cells than the conventional surgery.

  16. Comparative evaluation of two reconstructive methods following laparoscopic assisted subtotal gastrectomy in dogs

    Directory of Open Access Journals (Sweden)

    Bakhtiari Jalal

    2012-12-01

    Full Text Available Abstract Background Laparoscopic gastrectomy is a new and technically challenging surgical procedure with potential benefit. The objective of this study was to investigate clinical and para-clinical consequences following Roux-en-Y and Jejunal Loop interposition reconstructive techniques for subtotal gastrectomy using laparoscopic assisted surgery. Results Following resection of the stomach attachments through a laparoscopic approach, stomach was removed and reconstruction was performed with either standard Roux-en-Y (n = 5 or Jejunal Loop interposition (n = 5 methods. Weight changes were monitored on a daily basis and blood samples were collected on Days 0, 7 and 21 post surgery. A fecal sample was collected on Day 28 after surgery to evaluate fat content. One month post surgery, positive contrast radiography was conducted at 5, 10, 20, 40, 60 and 90 minutes after oral administration of barium sulfate, to evaluate the postoperative complications. There was a gradual decline in body weight in both experimental groups after surgery (P  0.05. Fecal fat content increased in the Roux-en-Y compared to the Jejunal loop interposition technique (P  0.05. Conclusion Roux-en-Y and Jejunal loop interposition techniques might be considered as suitable approaches for reconstructing gastro-intestinal tract following gastrectomy in dogs. The results of this study warrant further investigation with a larger number of animals.

  17. Primary Squamous Cell Carcinoma of the Remnant Stomach after Subtotal Gastrectomy.

    Science.gov (United States)

    Chang, Yeon Soo; Kim, Min Sung; Kim, Dong Hee; Park, Seulkee; You, Ji Young; Han, Joon Kil; Kim, Seong Hwan; Lee, Ho Jung

    2016-06-01

    Primary squamous cell carcinoma (SCC) of the stomach is a very rare disease. However, the pathogenesis, clinical characteristics, and prognosis of gastric SCC are controversial and remain to be elucidated. Herein, we report a case of primary gastric SCC of the remnant stomach after subtotal gastrectomy. A 65-year-old man was admitted to our hospital due to epigastric discomfort and dizziness. He had undergone subtotal gastrectomy 40 years previously for gastric ulcer perforation. Endoscopy revealed a normal esophagus and a large mass in the remnant stomach. Abdominal computed tomography revealed enhanced wall thickening of the anastomotic site and suspected metachronous gastric cancer. Endoscopic biopsy revealed SCC. Total gastrectomy was performed with Roux-en-Y esophagojejunostomy. A 10-cm tumor was located at the remnant stomach just proximal to the previous area of anastomosis. Pathologic examination showed well-differentiated SCC extended into the subserosa without lymph node involvement (T3N0M0). The patient received adjuvant systemic chemotherapy with 6 cycles of 5-FU and cisplatin regimen, and he is still alive at the 54-month follow-up. According to the treatment principles of gastric cancer, early detection and radical surgical resection can improve the prognosis. PMID:27433399

  18. Laparoscopic-assisted gastrectomy versus open gastrectomy for T4a gastric cancer in short-term and long-term outcomes.

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Objective:To study thesafety of oncologic short-term and long-term outcomes of laparoscopic-assisted gastrectomy (LAG) performed for T4a stage gastric cancer. Methods: Between January 2009 and December 2014, 86 patients with American Joint Committee on Cancer (AJCC) stage T4a gastric cancer underwent LAG or conventional open gastrectomy (OG). Of these patients, 43 patients underwent LAG and they were compared with patients who underwent OG regarding short-term and long-term outcome. Results:The N stage (P=0.685) did not differ between the LAG and OG groups. Postoperative morbidity occurred in 6 (14.0%) OG and 8 (9.3%) LAG cases and postoperative mortality occurred 2 (4.0%) and 0 (0.0%) cases of OG and LAG, respectively. Recurrence occurred in 6 (14.0%) cases and 4 (9.3%) case in the OG and LAG group, respectively (P=0.077). hTe mean survival time in the OG group was 53.86 m)and in the LAG was 53.97 m with no signiifcant difference (P=0.295).Conclusion:The LAG is a feasible and safe procedure, and has several advantages over conventional OG.

  19. A calculation on the diffusion and release behavior of fission products in the first and second OGL-1 fuel sleeves

    International Nuclear Information System (INIS)

    Based on the Fick's law the computer program FPDR has been developed to calculate the one-dimensional diffusion and release behavior of fission products in the graphite sleeves of the first and second OGL-1 fuel assembly. Through the comparison between the measured and calculated penetration profiles, the diffusion coefficient of 90Sr in the first fuel sleeve has been estimated to be (2 -- 5) x 10-13 m2/s; those of 137Cs and 90Sr in the second fuel sleeve around or larger than 1 x 10-12 m2/s, and --10-14 m2/s, respectively. The release of 90Sr from the second fuel sleeve is negligible; that of 137Cs depends linearly on its diffusion coefficient if the coefficient is larger than 10-12 m2/s, but practically does not depend on its evaporation parameter. (author)

  20. Outcome after gastrectomy in gastric cancer patients with type 2 diabetes

    Institute of Scientific and Technical Information of China (English)

    Jong Won Kim; Jae-Ho Cheong; Woo Jin Hyung; Seung-Ho Choi; Sung Hoon Noh

    2012-01-01

    AIM: To evaluate the prognosis of type Ⅱ diabetes mellitus (T2DM) after gastrectomy and related factors in gastric cancer patients. METHODS: 403 gastric cancer patients with T2DM were studied, who underwent gastrectomy between May 2003 and September 2009. A review of medical records and telephone interviews was performed in this cross-sectional study. The factors included in the statistical analysis were as follows: gender, age, type of surgery, preoperative body mass index (BMI), current BMI, BMI reduction ratio, preoperative insulin or oral diabetic medicine requirement, follow-up duration, and current state of diabetes. Assessment of diabetes status after surgery was classified into four categories according to the change in hypoglycemic agents after surgery and present status of T2DM: resolution, improvement, same, and worse. RESULTS: The mean follow-up duration was 33.7 mo (± 20.6 mo), preoperative BMI was 24.7 kg/m2 (± 3.0 kg/m2), and BMI reduction ratio was 9.8% (± 8.6%). After surgery, T2DM was cured in 58 patients (15.1%) and was improved in 117 patients (30.4%). According to the type of surgery, the BMI reduction ratio was significantly higher in the total gastrectomy and Roux-en-Y reconstruction group [14.2% ± 9.2% vs 9.2% ± 7.7% (Billroth Ⅱ group), P < 0.001] and significantly lower in the subtotal gastrectomy and Billroth Ⅰ reconstruction group [7.6% ± 8.0%, 9.2% ± 7.7% (Billroth Ⅱ group), P < 0.001]. The BMI reduction ratio, follow-up duration after surgery, type of surgery, extent of gastrectomy, and performance of duodenal bypass were significantly correlated to the course of T2DM (P < 0.05). The BMI reduction ratio was the most influential factor on T2DM status. In a subgroup analysis of patients with a BMI reduction ratio of 10% or less (n = 206), T2DM was cured in 15 (7.6%) patients and was improved in 57 (28.8%) patients after surgery, and only the duration of surgery was significantly correlated to T2DM status (P = 0

  1. Management of a case of left tracheal sleeve pneumonectomy under cardiopulmonary bypass: Anesthesia perspectives

    Directory of Open Access Journals (Sweden)

    Aman Jyoti

    2014-01-01

    Full Text Available The lung tumors with carinal involvement are frequently managed with tracheal sleeve pneumonectomy and tracheobronchial anastomosis without use of cardiopulmonary bypass (CPB. Various modes of ventilation have been described during tracheal resection and anastomosis. Use of CPB during this period allows the procedure to be conducted in a more controlled way. We performed tracheal sleeve pneumonectomy for adenoid cystic carcinoma of left lung involving carina. The surgery was performed in two stages. In the first stage, left pneumonectomy was performed and in the second stage after 48 h, tracheobronchial resection and anastomosis was performed under CPB. Second stage was delayed to avoid excessive bleeding (due to heparinization from the extensive vascular raw area left after pneumonectomy. Meticulous peri-operative planning and optimal post-operative care helped in successful management of a complex case, which is associated with high morbidity and mortality.

  2. Compact YAG laser welding system and its in-process monitoring in sleeving technology

    International Nuclear Information System (INIS)

    With respect to laser sleeve repairing by YAG laser welding for damaged sections of S/G tubes in nuclear power plants, about 40,000 sleeves have already been welded up to now. After replacement of S/Gs, it is considered that the quantity of such large-scale working will decrease and small-scale working will be carried out. Therefore, the authors have developed utilization of a 1kW YAG laser oscillator of a compact single-rod type mountable in reactor containment vessels, together with a small-diameter tube welding tool of 12mm in O.D. applicable to heat exchanger tubes of 3/4 in. Further, they have put such a system to practical use that can monitor deterioration of optical parts and welding conditions in process during welding by extracting the radiation intensity of the welded area with monitoring fibers. In this paper, they will report the results of study

  3. Irradiation-induced dimensional changes of fuel compacts and graphite sleeves of OGL-1 fuel assemblies

    International Nuclear Information System (INIS)

    Experimental data are summarized on irradiation-induced dimensional changes of fuel compacts and graphite sleeves of the first to ninth OGL-1 fuel assemblies. The range of fast-neutron fluence is up to 4 x 1024 n/m2 (E > 0.18 MeV); and that of irradiation temperature is 900 - 1400 deg C for fuel compacts and 800 - 1050 deg C for graphite sleeves. The dimensional change of the fuel compacts was shrinkage under these test conditions, and the shrinkage fraction increased almost linearly with fast-neutron fluence. The shrinkage fraction of the fuel compacts was larger by 20 % in the axial direction than in the radial direction. Influence of the irradiation temperature on the dimensional-change behavior of the fuel compacts was not observed clearly; presumably the influence was hidden by scatter of the data because of low level of the fast-neutron fluence and the resultant small dimensional changes. (author)

  4. Numerical Simulation and Experimental Validation of an Integrated Sleeve-Wedge Anchorage for CFRP Rods

    DEFF Research Database (Denmark)

    Schmidt, Jacob Wittrup; Smith, Scott T.; Täljsten, Björn;

    2011-01-01

    The tensioning of carbon fibre-reinforced polymer (CFRP) rods for prestressed concrete applications or post-tensioning repair and strengthening has met with mixed success. This is primarily due to limitations inherent in the use of traditional wedge anchors typically used for steel tendons....... Recently, an integrated sleeve-wedge anchorage has been successfully developed specifically for CFRP rods. This paper in turn presents a numerical simulation of the newly developed anchorage using ABAQUS. The three-dimensional finite element (FE) model, which considers material non-linearity, uses...... hexagonal elements for the barrel and CFRP rod and tetrahedral elements for the integrated sleeve-wedge. The simulated barrel surface strains are shown to compare well with optically measured strains, however, the numerical results are shown to be sensitive to the mechanical properties of the anchorage...

  5. Analysis of risk factors for the interval time, number and pattern of hepatic metastases from gastric cancer after radical gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Jing-Yu Deng; Han Liang; Dan Sun; Hong-Jie Zhan; Ru-Peng Zhang

    2008-01-01

    AIM: To analyze the risk factors for interval time,number and pattern of hepatic metastases from gastric cancer after radical gastrectomy, and provide evidence for predicting and preventing hepatic metastasis from gastric cancer after radical gastrectomy. METHODS: A retrospective study of 87 patients with hepatic metastasis who underwent radical gastrectomy for gastric cancer from 1996 to 2001. The data was analyzed to evaluate significant risk factors for interval time, number and pattern of hepatic metastases originating from gastric cancer after radical gastrectomy.RESULTS: The size of gastric cancer and lymph node metastases were independently correlated with the interval time of hepatic metastases; the depth of invasion was independently correlated with the number of hepatic metastases; while the depth of invasion and Lauren classification were independently correlated with the pattern of hepatic metastases.CONCLUSION: We evaluated the interval time of hepatic metastases with the size of gastric cancer and lymph node metastases. The depth of invasion could be used to evaluate the number of hepatic metastases, while the depth of invasion and the Lauren classification could be used to evaluate the pattern of hepatic metastases in patients who underwent radical gastrectomy.

  6. A Case of Laparoscopic Resection for Carcinoma of the Gastric Remnant following Proximal Gastrectomy Reconstructed with Jejunal Interposition

    Directory of Open Access Journals (Sweden)

    Kazuhito Yajima

    2016-01-01

    Full Text Available A 72-year-old Japanese man had a history of proximal gastrectomy for early gastric cancer located in the upper third of the stomach in 2007. Our usual treatment strategy for early gastric cancer in the upper third of the stomach in 2007 was open proximal gastrectomy reconstructing by jejunal interposition with a 10 cm single loop. Upper gastrointestinal fiberscopy for annual follow-up revealed a type 0-IIc-shaped tumor with ulcer scar, 4.0 cm in size, located in the gastric remnant near the jejunogastrostomy. A clinical diagnosis of cancer of the gastric remnant, clinical T1b(SMN0M0, Stage IA, following the proximal gastrectomy was made and a laparoscopic approach was selected because of the cancer’s early stage. Remnant total gastrectomy with D1 plus lymphadenectomy was carried out with five ports by a pneumoperitoneal method. Complete resection of the reconstructed jejunum was undergone along with the jejunal mesentery. Reconstruction by the Roux-en-Y method via the antecolic route was selected. Total operative time was 395 min and blood loss was 40 mL. Our patient was the first successful case of resection for carcinoma of the gastric remnant following proximal gastrectomy reconstructed with jejunal interposition in a laparoscopic approach.

  7. A Case of Laparoscopic Resection for Carcinoma of the Gastric Remnant following Proximal Gastrectomy Reconstructed with Jejunal Interposition

    Science.gov (United States)

    Iwasaki, Yoshiaki; Yuu, Ken; Oohinata, Ryouki; Amaki, Misato; Kohira, Yoshinori; Natsume, Souichiro; Ishiyama, Satoshi; Takahashi, Keiichi

    2016-01-01

    A 72-year-old Japanese man had a history of proximal gastrectomy for early gastric cancer located in the upper third of the stomach in 2007. Our usual treatment strategy for early gastric cancer in the upper third of the stomach in 2007 was open proximal gastrectomy reconstructing by jejunal interposition with a 10 cm single loop. Upper gastrointestinal fiberscopy for annual follow-up revealed a type 0-IIc-shaped tumor with ulcer scar, 4.0 cm in size, located in the gastric remnant near the jejunogastrostomy. A clinical diagnosis of cancer of the gastric remnant, clinical T1b(SM)N0M0, Stage IA, following the proximal gastrectomy was made and a laparoscopic approach was selected because of the cancer's early stage. Remnant total gastrectomy with D1 plus lymphadenectomy was carried out with five ports by a pneumoperitoneal method. Complete resection of the reconstructed jejunum was undergone along with the jejunal mesentery. Reconstruction by the Roux-en-Y method via the antecolic route was selected. Total operative time was 395 min and blood loss was 40 mL. Our patient was the first successful case of resection for carcinoma of the gastric remnant following proximal gastrectomy reconstructed with jejunal interposition in a laparoscopic approach. PMID:27034881

  8. Beare-Stevenson syndrome: two new patients, including a novel finding of tracheal cartilaginous sleeve.

    Science.gov (United States)

    Wenger, Tara L; Bhoj, Elizabeth J; Wetmore, Ralph F; Mennuti, Michael T; Bartlett, Scott P; Mollen, Thomas J; McDonald-McGinn, Donna M; Zackai, Elaine H

    2015-04-01

    Beare-Stevenson syndrome (BSS) is a rare FGFR2-associated craniosynostosis syndrome with a higher rate of sudden unexplained death than related conditions such as Apert, Pfeiffer, and Crouzon syndromes. BSS presents with craniosynostosis, cutis gyrata, and significant developmental delay in most patients who survive infancy. There have only been 21 reported patients with BSS, which limits prognostication for clinicians and likely does not capture the full extent of the phenotype. Here we report on two additional patients with molecularly confirmed BSS, one each with p.Ser372Tyr and p.Tyr375Cys mutations in FGFR2. Cloverleaf skull was identified prenatally in one patient, with initial concern for Crouzon syndrome. Prenatal 3D ultrasound was performed, but cutis gyrata was only visible on retrospective examination following the clinical diagnosis of BSS after birth. Due to phenotypic overlap with Crouzon syndrome, but worse prognosis, we recommend consideration of prenatal 3D ultrasound and mutation testing for patients with suspected Crouzon to allow for prenatal diagnosis of BSS and to enable appropriate genetic counseling and postnatal care. One of our patients was noted to have a tracheal cartilaginous sleeve, which if present could explain sudden death. Of note, tracheal cartilaginous sleeves have been reported in other FGFR2-related craniosynostosis syndromes, and are associated with 90% risk of death by two years of age without tracheostomy. Tracheal cartilaginous sleeves are often only found incidentally at autopsy as they are difficult to diagnose without direct visualization of the trachea. This association and our experience suggests that BSS patients be evaluated for tracheal cartilaginous sleeve to prevent airway compromise. PMID:25706251

  9. DURABILITY-RELATED CHARACTERISTICS OF DOUBLE-LAYER STRUCTURES OF PIPELINES CONNECTED TO POLYMERIC SLEEVES

    Directory of Open Access Journals (Sweden)

    Orlov Vladimir Alexandrovich

    2012-10-01

    The ultimate objective of the software programme is to assess the applicability of the trenchless repair method involving a polymeric sleeve in each specific case by taking account of the environment and the condition of the pipeline. The software is also capable of developing the requirements to be fulfilled by subcontractors in order to assure the appropriate quality of any repair work performed and the reliability of any pipeline sections repaired.

  10. Duodenal-jejunal bypass sleeve - a potential alternative to bariatric surgery?

    DEFF Research Database (Denmark)

    Rohde, Ulrich; Gylvin, Silas; Vilmann, Peter;

    2014-01-01

    Overweight and obesity are risk factors for several co-morbidities reducing life expectancy. Conservative treatment of obesity is generally ineffective in the long-term. Bariatric surgery has proven effective, but is associated with potential complications. Duodenal-jejunal bypass sleeve is a novel...... minimal invasive and fully reversible endoscopic treatment modality approved for treatment of obesity with or without concomitant type 2 diabetes. Here we review present data for the efficacy and safety of this treatment modality....

  11. Split mandrel versus split sleeve coldworking: Dual methods for extending the fatigue life of metal structures

    Science.gov (United States)

    Rodman, Geoffrey A.; Creager, Matthew

    1994-01-01

    It is common practice to use split sleeve coldworking of fastener holes as a means of extending the fatigue life of metal structures. In search of lower manufacturing costs, the aerospace industry is examining the split mandrel (sleeveless) coldworking process as an alternative method of coldworking fastener holes in metal structures. The split mandrel process (SpM) significantly extends the fatigue life of metal structures through the introduction of a residual compressive stress in a manner that is very similar to the split sleeve system (SpSl). Since the split mandrel process is significantly less expensive than the split sleeve process and more adaptable to robotic automation, it will have a notable influence upon other new manufacture of metal structures which require coldworking a significant number of holes, provided the aerospace community recognizes that the resulting residual stress distributions and fatigue life improvement are the same for both processes. Considerable testing has validated the correctness of that conclusion. The findings presented in this paper represent the results of an extensive research and development program, comprising data collected from over 400 specimens fabricated from 2024-T3 and 7075-T651 aluminum alloys in varied configurations, which quantify the benefits (fatigue enhancement and cost savings) of automating a sleeveless coldworking system.

  12. Decoding static and dynamic arm and hand gestures from the JPL BioSleeve

    Science.gov (United States)

    Wolf, M. T.; Assad, C.; Stoica, A.; You, Kisung; Jethani, H.; Vernacchia, M. T.; Fromm, J.; Iwashita, Y.

    This paper presents methods for inferring arm and hand gestures from forearm surface electromyography (EMG) sensors and an inertial measurement unit (IMU). These sensors, together with their electronics, are packaged in an easily donned device, termed the BioSleeve, worn on the forearm. The gestures decoded from BioSleeve signals can provide natural user interface commands to computers and robots, without encumbering the users hands and without problems that hinder camera-based systems. Potential aerospace applications for this technology include gesture-based crew-autonomy interfaces, high degree of freedom robot teleoperation, and astronauts' control of power-assisted gloves during extra-vehicular activity (EVA). We have developed techniques to interpret both static (stationary) and dynamic (time-varying) gestures from the BioSleeve signals, enabling a diverse and adaptable command library. For static gestures, we achieved over 96% accuracy on 17 gestures and nearly 100% accuracy on 11 gestures, based solely on EMG signals. Nine dynamic gestures were decoded with an accuracy of 99%. This combination of wearableEMGand IMU hardware and accurate algorithms for decoding both static and dynamic gestures thus shows promise for natural user interface applications.

  13. Laparoscopy-assisted gastrectomy with D2 lymph node dissection for advanced gastric cancer without serosa invasion: a matched cohort study from South China

    Directory of Open Access Journals (Sweden)

    Lin Jian-Xian

    2013-01-01

    Full Text Available Abstract Background Gastric cancer is a common malignancy worldwide and a common cause of death from cancer. Despite recent advances in multimodality treatment and targeted therapy, complete resection remains the only treatment that can lead to cure. This study was devised to investigate the technical feasibility, safety and oncologic efficacy of laparoscopy-assisted gastrectomy for advanced gastric cancer without serosa invasion. Methods A retrospective matched cohort study was performed in south China comparing laparoscopy-assisted gastrectomy and open gastrectomy for advanced gastric cancer without serosa invasion. Eighty-three patients with advanced gastric cancer undergoing laparoscopy-assisted gastrectomy between January 2008 and December 2010 were enrolled. These patients were compared with 83 patients with advanced gastric cancer undergoing open gastrectomy during the same period. Results There was no significant difference in clinicopathologic characteristics between the two groups. Regarding perioperative characteristics, the operation time and time to ground activities did not differ between the two groups, whereas the blood loss, transfused patient number, time to first flatus, time to resumption of diet, and postoperative hospital stay were significantly less in laparoscopy-assisted gastrectomy than in open gastrectomy (P Conclusion Laparoscopy-assisted gastrectomy with D2 lymphadenectomy is a safe and feasible procedure for advanced gastric cancer without serosa invasion. To be accepted as a choice treatment for advanced gastric cancer, well-designed randomized controlled trials comparing short-term and long-term outcomes between laparoscopy-assisted gastrectomy and open gastrectomy in a larger number of patients are necessary.

  14. Stem cell impregnated nanofiber stent sleeve for on-stent production and intravascular delivery of paracrine factors.

    Science.gov (United States)

    Hwang, Chao-Wei; Johnston, Peter V; Gerstenblith, Gary; Weiss, Robert G; Tomaselli, Gordon F; Bogdan, Virginia E; Panigrahi, Asmi; Leszczynska, Aleksandra; Xia, Zhiyong

    2015-06-01

    Stem cell therapies for atherosclerotic diseases are promising, but benefits remain modest with present cell delivery devices in part due to cell washout and immune attack. Many stem cell effects are believed mediated by paracrine factors (PFs) secreted by the stem cells which potentiate tissue repair via activation and enhancement of intrinsic host repair mechanisms We therefore sought to create an "intravascular paracrine factor factory" by harnessing stem cells on a stent using a nanofiber (NF) stent sleeve, and thus providing a sheltered milieu for cells to continuously produce PFs on-stent. The NF sleeve acts as a substrate on which stem cells grow, and as a semi-permeable barrier that protects cells from washout and host immune response while allowing free outward passage of PFs. NF stent sleeves were created by covering stents with electrospun poly-lactic-co-glycolic acid nanofibers and were then uniformly coated with mesenchymal stem cells (MSCs). NF sleeves blocked cell passage but did not hamper MSC attachment or proliferation, and did not alter MSC morphology or surface markers. NF sleeve MSCs continued to secrete PFs that were biologically active and successfully induced tubulogenesis in human endothelial cells. NF stent sleeves seeded with allogeneic MSCs implanted in pigs remained patent at 7 days without thrombotic occlusion or immune rejection. Our results demonstrate the feasibility of creating an intravascular PF factory using a stem cell impregnated NF stent sleeve, and pave the way for animal studies to assess the efficacy of local PF production to treat ischemic artery disease. PMID:25818438

  15. Liver function alterations after laparoscopy-assisted gastrectomy for gastric cancer and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    Gui-Ae Jeong; Gyu-Seok Cho; Eung-Jin Shin; Moon-Soo Lee; Hyung-Chul Kim; Ok-Pyung Song

    2011-01-01

    AIM: To evaluate the factors associated with liver function alterations after laparoscopy-assisted gastrectomy(LAG) for gastric cancer.METHODS: We collected the data of gastrectomy patients with gastric cancer and divided them into 2 groups: open gastrectomy (OG) and LAG. We also collectedthe data of patients with colon cancer to evaluate the effect of liver manipulations during surgery on liver function alterations. Serum aspartate aminotransferase(AST), alanine aminotransferase (ALT), total bilirubin,and alkaline phosphatase were measured on the preoperative day and postoperative day 1 (POD1), POD3,POD5, and POD7.RESULTS: No changes in liver function were observed after the operation in patients with colon cancer (n =121). However, in gastric cancer patients (n = 215),AST and ALT levels increased until POD5 compared to those in colon cancer patients and these findings were observed both in the LAG and OG without a significantsignificant difference except at POD1. The mean hepatic enzyme levels at POD1 in the LAG group were significantly higher than those in the OG group (P = 0.047for AST and P = 0.039 for ALT). The factors associated with elevated ALT on POD1 in patients with gastric cancer were body mass index (P < 0.001), operationtime (P < 0.001), intraoperative hepatic injury (P =0.048), and ligation of an aberrant left hepatic artery(P = 0.052) but not type of operation (OG vs LAG, P =0.094).CONCLUSION: We conclude that the liver function alteration after LAG may have been caused by direct liver manipulation or aberrant hepatic artery ligation rather than the CO2 pneumoperitoneum.

  16. Gastrectomy for gastric carcinoma with situs inversus totalis: case report and literature review

    Science.gov (United States)

    Zhu, H; Yang, K; Hu, JK

    2015-01-01

    Background: Situs inversus totalis (SIT), a rare congenital anomaly, is characterized by a complete mirror image transposition of the thoracic and abdominal viscera. We report the case of a 66-year-old woman with SIT who was diagnosed with gastric antral carcinoma. Curative distal gastrectomy with Billroth-I anastomosis was performed. Description of the case: A 66-year-old woman visited our outpatient department complaining of abdominal pain in the left upper quadrant for about one year. Physical examination revealed that the apex beat was in the right fifth intercostal space, just at the midclavicular line while a soft systolic murmur was audible at the upper right sternal border. The abdominal examination was unremarkable. The preoperative diagnosis was confirmed by gastroscopy and biopsy. Preoperative echocardiogram revealed the presence of dextrocardia and atrial septal defect. Preoperative contrasted computed tomography showed a complete right-left reversal of the thoracic and abdominal organs and thickened wall of gastric antrum without distant metastasis. Laparotomy through a midline incision confirmed the complete mirror-image transposition of the abdominal visceral organs and a 4-cm tumor with serosal involvement at the gastric antrum. Curative distal gastrectomy with D2 lymphadenectomy and Billroth-I anastomosis was performed. The patient had a rapid recovery and was discharged without any complications. The final staging of this case was pT4aN1M0, stage IIIa and she received chemotherapy with the SOX regimen for three cycles. Fifteen months after the operation, the patient is alive without any signs of recurrence. Conclusions: The incidence of gastric cancer with SIT is very rare. Appropriate diagnostic modalities are very helpful for the diagnosis and preoperative planning. Gastrectomy with D2 lymphadenectomy in patients with SIT can be performed successfully with sufficient preoperative evaluation, comprehensive knowledge of anatomy, and meticulous

  17. Rabeprazole is effective for bile reflux oesophagitis after total gastrectomy in a rat model

    Institute of Scientific and Technical Information of China (English)

    Naoki; Hashimoto

    2015-01-01

    AIM:To elucidate the effect of a proton pump inhibitor(PPI,rabeparazole)on oesophageal bile reflux in oesophagitis after total gastrectomy.METHODS:Twenty-one 8-week-old male Wistar rats were studied.They were performed oesophagoduodenostomy of total gastrectomy to induce oesophageal reflux of biliary and pancreatic juice.Five rats were performed the sham operation(Sham).On post-operative day 7,they were treated with saline(Control)(n=8)or PPI(rabeprazole,30 mg/kg per day,ip)(n=8)for 2 wk.On post-operative 21,all rats were sacrificed and each oesophagus was evaluated histologically.Oesophageal injury was evaluated by macroscopic and microscopic findings as well as the expression of cyclooxygenase-2(COX2).We measured bile acid in the oesophageal lumen and the common bile duct.RESULTS:At 3 wk after surgery,a histological study analysis revealed an increase in the thickness of the epithelium,elongation of the lamina propria and basal cell hyperplasia in the oesophageal mucosa.The macroscopic ulcer score and microscopic ulcer length of the control group were significantly higher compared to those of the rabeprazole-treated group.The expression of COX2 was significantly increased according to the immunostaining in the control group compared to rabeprazole-treated group.Although there was no difference between the control and PPI groups in the total bile acid in the common bile duct,the bileacid activity in the oesophageal lumen was significantly decreased in the rabeprazole-treated group due to augmentation of the duodenal motor complex.CONCLUSION:With this model,rabeprazole is good effect for reflux esophagitis after total gastrectomy from bile reflux.Bile acid is an important factor in the mucosal lesion induced by duodenal reflux.

  18. Influence of Delayed Gastric Emptying in Radiotherapy after a Subtotal Gastrectomy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hyun; Kim, Won Taek; Lee, Mi Ran; Ki, Yong Gan; Nam, Ji Ho; Park, Dal; Jeon, Ho Sang; Jeon, Kye Rok; Kim, Dong Won [Pusan National University of Medicine, Busan (Korea, Republic of)

    2009-12-15

    This aim of this study was to evaluate changes in gastric volume and organ position as a result of delayed gastric emptying after a subtotal gastrectomy performed as part of the treatment of stomach cancer. The medical records of 32 patients who underwent concurrent chemoradiotherapy after a subtotal gastrectomy from March 2005 to December 2008 were reviewed. Of these, 5 patients that had more than 50 cc of residual gastric food detected at computed tomography (CT) simulation, were retrospectively enrolled in this study. Gastric volume and organ location was measured from CT images obtained before radiotherapy, twice weekly. In addition, authors evaluated the change of radiation dose distribution to planning the target volume and normal organ in a constant radiation therapy plan regardless of gastric volume variation. A variation in the gastric volume was observed during the radiotherapy period (64.2{approx}340.8 cc; mean, 188.2 cc). According to the change in gastric volume, the location of the left kidney was shifted up to 0.7 - 2.2 cm (mean, 1.2 cm) in the z-axis. Under-dose to planning target volume (V43, 79.5{+-}10.4%) and over-dose to left kidney (V20, 34.1{+-}12.1%; Mean dose, 23.5{+-}8.3 Gy) was expected, given that gastric volume change due to delayed gastric emptying wasn't taken into account. This study has shown that a great change in gastric volume and left kidney location may occur during the radiation therapy period following a subtotal gastrectomy, as a result of delayed gastric emptying. Detection of patients who experienced delayed gastric emptying and the application of gastric volume variation to radiation therapy planning will be very important.

  19. Hereditary diffuse gastric cancer: genetics, prophylactic total gastrectomy, and follow up

    Directory of Open Access Journals (Sweden)

    Shenoy S

    2011-04-01

    Full Text Available Santosh Shenoy1, Carl Palmer2, Teresa Dunsworth3, Stephen McNatt41Department of Surgery, Louis A Johnson VA Medical Center, Clarksburg, WV, USA; 2Department of Medicine, West Virginia University, General Internal Medicine and Geriatrics, Morgantown, WV, USA; 3General Internal Medicine and Geriatrics, West Virginia University, Morgantown, WV, USA; 4Department of Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USABackground: Germline truncating mutations in the E-cadherin (CDH1 gene have been identified in families with hereditary diffuse gastric cancer (HDGC and lobular breast cancers. This disease entity has an autosomal dominant pattern of inheritance with approximately 70% to 80% penetrance. Currently there is no definitive diagnostic modality for surveillance to detect this form of gastric cancer (GC which carries a poor prognosis and high mortality. Prophylactic total gastrectomy is an option in the affected carriers and may offer improved long term survival for HDGC.Methods: Two siblings from a single family with multi generation history of GC were identified as carriers of the mutation. After genetic counseling, they underwent laparoscopic prophylactic total gastrectomy with Roux-en-y esophagojejunostomy reconstruction. We describe the demographics and pedigree analysis, and postoperative and 5-year outcomes, and review the literature.Results: Pathologic examination of the stomach revealed no foci of cancer in Patient 1; evidence of foci of gastric cancer was noted in Patient 2. Patient 2 subsequently developed lobular carcinoma of breast and underwent prophylactic bilateral mastectomy. No metastatic disease has been noted at 5-year follow up. She also had a successful pregnancy and birth of a healthy baby 3 years post gastrectomy. Both patients had a 30 to 40 lbs (13.5 to 18 kg permanent weight loss. Both patients have maintained their preoperative activities and occupations.Conclusion: HDGC is an uncommon

  20. Ghrelin and gastrin in advanced gastric cancer before and after gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Anna Zub-Pokrowiecka; Kazimierz Rembiasz; Peter C Konturek; Andrzej Budzyński; Stanis(l)aw J Konturek; Marek Winiarski; W(l)adys(l)aw Bielański

    2011-01-01

    AIM: To investigate plasma ghrelin, gastrin and growth hormone secretagogue receptor (GHS-R) expression in advanced gastric cancer (GC) before and after resection. METHODS: Seventy subjects in whom endoscopy of the upper gastrointestinal tract was performed in the Department of General Surgery at Cracow University during the past decade: (1) 25 patients with GC associated with Helicobacter pylori (H. pylori ) infection; (2) 10 patients with GC 4-5 years after (total or subtotal) gastrectomy; (3) 25 healthy H. pylori -negative controls, matched by age and BMI to the above two groups; and (4) 10 GC patients 4-5 years after total gastrectomy. Ghrelin and gastrin plasma concentrations were measured by specific radioimmunoassay under fasting conditions and postprandially at 60 and 90 min after ingestion of a mixed meal. GHS-R expression was examined in biopsy samples from intact healthy mucosa and GC tissue using semi-quantitative reverse transcriptionpolymerase chain reaction. RESULTS: In healthy controls, fasting plasma ghrelin levels were significantly elevated and declined markedly at 60 and 90 min after a mixed meal. The concomitant enhanced ghrelin, GHS-R and gastrin expression in GC tissue over that recorded in intact mucosa, and the marked rise in plasma gastrin in these subjects under fasting conditions indicate the role of these hormonal factors in GC formation. Fasting plasma levels and postprandial response of ghrelin and gastrin appear to be inversely correlated in healthy subjects. Feeding in the controls resulted in a significant fall in plasma ghrelin with a subsequent rise in plasma gastrin, but in H. pylori -positive GC patients submitted to total or distal gastrectomy, feeding failed to affect significantly the fall in plasma ghrelin that was recorded in these patients before surgery. Fasting ghrelin concentrations were significantly lower in patients 4-5 years after total gastrectomy compared to those in healthy controls and to these in GC patients

  1. Colonic Perforation Caused by Methicillin-Resistant Staphylococcus aureus Enteritis After Total Gastrectomy: A Case Report.

    Science.gov (United States)

    Furukawa, Kenei; Tsutsumi, Jun; Takayama, Sumio; Mashiko, Hiroshi; Shiba, Hiroaki; Yanaga, Katsuhiko

    2015-03-01

    A 68-year-old man underwent total gastrectomy and splenectomy for adenocarcinoma and low anterior resection for carcinoma in tubulo-villous adenoma of the rectum. Broad-spectrum antibiotics were administered for postoperative pancreatic fistula. Methicillin-resistant Staphylococcus aureus enteritis occurred on the 50th postoperative day and cecal perforation followed. The patient underwent construction of cecostomy with peritoneal drainage, and vancomycin was administered orally and per cecostomy for 2 weeks. The patient recovered well and was discharged at 35 days after re-operation in good general condition.

  2. Structure and properties of braided sleeve preforms for chemical vapor infiltration

    Energy Technology Data Exchange (ETDEWEB)

    Starr, T.L.; Fiadzo, O.G.; Hablutzel, N. [Georgia Inst. of Tech., Atlanta, GA (United States). School of Materials Science and Technology

    1998-04-01

    In all composites the properties and structure of the reinforcement strongly influence the performance of the material. For some composites, however, the reinforcement also affects the fabrication process itself exerting an additional, second order influence on performance. This is the case for the chemical vapor infiltration (CVI) process for fabrication of ceramic matrix composites. In this process the matrix forms progressively as a solid deposit, first onto the fiber surfaces, then onto the previous layer of deposit, ultimately growing to fill the inter-fiber porosity. The transport of reactants to the surfaces and the evolved morphology of the matrix depend on the initial reinforcement structure. This structure can vary greatly and is controlled by such factors as fiber size and cross-section, the number of filaments and amount of twist per tow or yarn, and the weave or braid architecture. Often the choice of reinforcement is based on mechanical performance analysis or on the cost and availability of the material or on the temperature stability of the fiber. Given this choice, the composite densification process--CVI--must be optimized to attain a successful material. Ceramic fiber in the form of cylindrical braided sleeve is an attractive choice for fabrication of tube-form ceramic matrix composites. Multiple, concentric layers of sleeve can be placed over a tubular mandrel, compressed and fixed with a binder to form a freestanding tube preform. This fiber architecture is different than that created by layup of plain weave cloth--the material used in most previous CVI development. This report presents the results of the investigation of CVI densification of braided sleeve preforms and the evolution of their structure and transport properties during processing.

  3. Safe major abdominal operations:Hepatectomy, gastrectomy and pancreatoduodenectomy in elder patients

    Institute of Scientific and Technical Information of China (English)

    Yu-Lian Wu; Jun-Xiu Yu; Bin Xu

    2004-01-01

    AIM: To evaluate the impact of advanced age on outcome after hepatectomy, gastrectomy and pancreatoduodenectomy.METHODS: Two hundreds and eleven patients undergone hepatectomy, gastrectomy and pancreatoduodenectomy from January 1998 to September 2002 were analyzed retrospectively. Clinicopathologic features and operative outcome of 83 patients aged 65 years or more were compared with that in 128 younger patients aged less than 65 years.RESULTS: The nutritional state, such as pre-operation level of serum albumin and hemoglobin in the older patients was poorer than that in the younger patients. The older patients had higher comorbidities than the younger patients (48.2%vs 15.6%). No significant difference was observed in perioperative mortality, and complication rate between the older and younger patients (2.4% vs 1.6% and 22.9% vs20.3%, respectively). Multivariate analysis demonstrated that pancreatoduodenectomy, hepatectomy with resection of more than 2 segments and comorbidities were independent predictors of postoperative complication, whereas age was not (P=0.3172).CONCLUSION: It is safe for patients aged 65 years or more to undergo hepatic, pancreatic and gastric resection if great care is taken during perioperative period.

  4. High prevalence of osteoporosis in patients with gastric adenocarcinoma following gastrectomy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To evaluate the prevalence and predictive factors of osteoporosis in patients with gastric adenocarcinoma after gastrectomy.METHODS: The study included 133 patients diagnosed with gastric adenocarcinoma but who did not undergo prior diagnostic work-up for osteoporosis. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) and vertebral deformity was assessed by plain X-rays. We evaluated the effects of age, sex, body mass index (BMI), anemia, back pain,vertebral deformity, tumor staging, reconstruction type,and past medical history to determine predictive factors of osteoporosis in these patients.RESULTS: The prevalence of osteoporosis in the lumbar spine was 38.3% (male, 28.9%; female, 54.0%), and 15.0% in the femoral neck (male, 10.8%; female,22.0%). The vertebral deformity rate was 46.6% (male,43.4%; female, 52.0%). Age, BMI and hemoglobin correlated with BMD (P < 0.01). In males, anemia and age > 64 years were independent predictive factors of osteoporosis in multivariate analysis. In females, back pain was an independent factor for osteoporosis.CONCLUSION: The results of this study revealed that prevalence of osteoporosis and vertebral bone deformity rate were high in gastric cancer patients, regardless of post-gastrectomy duration and operation type. Early diagnosis and a proper management plan must be established in these patients.

  5. Gastric Banding

    Science.gov (United States)

    ... gastric banding before deciding to have the procedure. Advertisements for a device or procedure may not include ... feeds Follow FDA on Twitter Follow FDA on Facebook View FDA videos on YouTube View FDA photos ...

  6. Evaluation of gastrectomy in patients with delayed gastric emptying after antireflux surgery or large hiatal hernia repair

    NARCIS (Netherlands)

    Gerritsen, A.; Furnee, E.J.B.; Gooszen, H.G.; Wondergem, M.; Hazebroek, E.J.

    2013-01-01

    BACKGROUND: Revision antireflux surgery and large hiatal hernia repair require extensive dissection at the gastroesophageal junction. This may lead to troublesome symptoms due to delayed gastric emptying, eventually requiring gastrectomy. The aim of this study was to evaluate the outcome of gastrect

  7. Repair boundary for parent tube indications within the upper joint zone of hybrid expansion joint (HEJ) sleeved tubes

    International Nuclear Information System (INIS)

    In the Spring and Fall of 1994, and the Spring of 1995, crack-like indications were found in the upper hybrid expansion joint (HEJ) region of Steam Generator (S/G) tubes which had been sleeved using Westinghouse HEJ sleeves. As a result of these findings, analytic and test evaluations were performed to assess the effect of the degradation on the structural, and leakage, integrity of the sleeve/tube joint relative to the requirements of the United States Nuclear Regulatory Commission's (NRC) draft Regulatory Guide (RG) 1.121. The results of these evaluations demonstrated that tubes with implied or known crack-like circumferential parent tube indications (PTIs) located 1.1 inches or farther below the bottom of the hardroll upper transition, have sufficient, and significant, integrity relative to the requirements of RG 1.121. Thus, the purpose of this report is to provide background information related to the justification of the modified tube repair boundary

  8. Repair boundary for parent tube indications within the upper joint zone of hybrid expansion joint (HEJ) sleeved tubes

    Energy Technology Data Exchange (ETDEWEB)

    Cullen, W.K.; Keating, R.F. [Westinghouse Electric, Pittsburgh, PA (United States)

    1997-02-01

    In the Spring and Fall of 1994, and the Spring of 1995, crack-like indications were found in the upper hybrid expansion joint (HEJ) region of Steam Generator (S/G) tubes which had been sleeved using Westinghouse HEJ sleeves. As a result of these findings, analytic and test evaluations were performed to assess the effect of the degradation on the structural, and leakage, integrity of the sleeve/tube joint relative to the requirements of the United States Nuclear Regulatory Commission`s (NRC) draft Regulatory Guide (RG) 1.121. The results of these evaluations demonstrated that tubes with implied or known crack-like circumferential parent tube indications (PTIs) located 1.1 inches or farther below the bottom of the hardroll upper transition, have sufficient, and significant, integrity relative to the requirements of RG 1.121. Thus, the purpose of this report is to provide background information related to the justification of the modified tube repair boundary.

  9. Distribution of fission products in graphite sleeves and blocks of the eleventh and twelfth OGL-1 fuel assemblies

    International Nuclear Information System (INIS)

    The 11th and 12th fuel assemblies were irradiated in an in-pile gas loop, OGL-1, installed in the Japan Materials Testing Reactor (JMTR) of Japan Atomic Energy Research Institute (JAERI). Distribution of fission products in the graphite sleeves and blocks of the assemblies was measured by gamma-ray spectrometry. The 11th fuel assembly was aimed at testing the irradiation performance of mass product fuels in trial manufacturing of the first charge fuel for the High Temperature Engineering Test Reactor (HTTR) in relatively short irradiation, and the 12th assembly in long-term irradiation. The 12th assembly attained a burnup approximately as high as that of the HTTR driver fuel design. In the graphite sleeve of the 11th assembly, high concentration peaks of fission products were found in the axial distribution. Exposure of failed fuel particles was not detected on the surface of fuel compacts, while fissures of graphite matrix at overcoat boundaries were observed on the surface. These results led to a presumption that fission products, which were released from failed particles located inside of the fuel compact, was easily transported through the fissures of the matrix to the inner surface of the sleeve. In the graphite sleeve of the 12th assembly, 110mAg was detected together with other fission products of 137Cs, 134Cs etc. Silver-110m showed characteristic distribution: this nuclides was less concentrated at the region with highly concentrated 60Co which is presumed to have been transported from melted sheath material of thermocouples to the graphite sleeve. It was inferred from the distribution that the transport behavior of 110mAg had been influenced by co-sorption or by pore structure change in the graphite material of the sleeve, which had been induced by metallic elements including cobalt. (author)

  10. Distribution of fission products in graphite sleeves and blocks of the eleventh and twelfth OGL-1 fuel assemblies

    Energy Technology Data Exchange (ETDEWEB)

    Hayashi, Kimio; Fukuda, Kousaku; Kikuchi, Teruo [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Tsuruta, Harumichi

    1994-06-01

    The 11th and 12th fuel assemblies were irradiated in an in-pile gas loop, OGL-1, installed in the Japan Materials Testing Reactor (JMTR) of Japan Atomic Energy Research Institute (JAERI). Distribution of fission products in the graphite sleeves and blocks of the assemblies was measured by gamma-ray spectrometry. The 11th fuel assembly was aimed at testing the irradiation performance of mass product fuels in trial manufacturing of the first charge fuel for the High Temperature Engineering Test Reactor (HTTR) in relatively short irradiation, and the 12th assembly in long-term irradiation. The 12th assembly attained a burnup approximately as high as that of the HTTR driver fuel design. In the graphite sleeve of the 11th assembly, high concentration peaks of fission products were found in the axial distribution. Exposure of failed fuel particles was not detected on the surface of fuel compacts, while fissures of graphite matrix at overcoat boundaries were observed on the surface. These results led to a presumption that fission products, which were released from failed particles located inside of the fuel compact, was easily transported through the fissures of the matrix to the inner surface of the sleeve. In the graphite sleeve of the 12th assembly, {sup 110m}Ag was detected together with other fission products of {sup 137}Cs, {sup 134}Cs etc. Silver-110m showed characteristic distribution: this nuclides was less concentrated at the region with highly concentrated {sup 60}Co which is presumed to have been transported from melted sheath material of thermocouples to the graphite sleeve. It was inferred from the distribution that the transport behavior of {sup 110m}Ag had been influenced by co-sorption or by pore structure change in the graphite material of the sleeve, which had been induced by metallic elements including cobalt. (author).

  11. Does Total Gastrectomy Provide Better Outcomes than Distal Subtotal Gastrectomy for Distal Gastric Cancer? A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Qi, Jin; Zhang, Peng; Wang, Yanan; Chen, Hao; Li, Yumin

    2016-01-01

    Background/Aims Total gastrectomy (TG) has shown to be superior regarding low risk of recurrence and readmission to distal subtotal gastrectomy (DG) for treatment of distal stomach cancer, but the incidence of postoperative morbidity and mortality in TG cannot be ignored. Therefore, we performed a meta-analysis to compare the effectiveness between TG and DG for distal stomach cancer. Methodology A search in PubMed, EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical Database through January 2016 was performed. Eligible studies in comparing of TG and DG for distal gastric cancer were included in this meta-analysis. Review Manager 5.2 software from the Cochrane Collaboration was used for the performance of meta-analysis and STATA 12.0 software for meta-regression analysis. Results Ten retrospective cohort studies and one randomized control trial involving 5447 patients were included. The meta-analysis showed no significant difference of postoperative mortality (RR = 1.48, 95%CI = 0. 90–2.44,p = 0.12), intraoperative blood loss (MD = 24.34, 95%CI = -3.31–51.99, p = 0.08) and length of hospital stay(MD = 0.76, 95%CI:-0.26–1.79, p = 0.15). TG procedure could retrieve more lymph nodes than DG(MD = 4.33, 95% CI = 2.34–6.31, p0.05). We pooled the data together, the accumulated 5-year Overall Survival rates of TG and DG groups were 49.6% (919/1852) vs.55.9%(721/1290) respectively. Meta-analysis revealed a favoring trend to DG procedure and there was a statistical difference between the two groups (RR = 0.91,95% CI = 0.85–0.97,p = 0.006). Conclusion Based on current retrospective evidences, we found that in spite of similar postoperative mortality, TG for distal gastric cancer provided a high risk of five-year Overall Survival rate. DG procedure can be a recommendation for distal gastric cancer, whereas due to lack of high quality RCTs in multicenter and the relatively small sample size of long-term outcomes, further comparative studies are still

  12. Injection Mould Design for Gear Sleeve%齿轮套注塑模设计

    Institute of Scientific and Technical Information of China (English)

    刘海渔

    2015-01-01

    在分析产品要求及成型工艺的基础上,设计了某玩具车齿轮套注塑模。根据产品结构,采用对称式扇形浇口;为提高成型效率,简化模具结构,采用斜导柱滑块抽芯机构,将侧抽滑块的滑槽设置在动模板上。并设计推管与推杆联合推出机构,从而有效地保证了产品的成型质量和生产效率。同时利用Pro/E软件提高了设计效率,缩短了产品开发周期。%On the analysis of product requirements and molding process,the injection mould for gear sleeve of toy vehicle was designed. The symmetric fan gate and ejector sleeve and the inclined guide pillar slider core pulling mechanism were adopted to improve molding efficiency based on product structure,and the side pumping chute slider was arranged in the movable template. At the same time,push tube and push rod joint institutions were designed to effectively ensure the product quality and production efficiency. By using Pro/E software,design efficiency was improved and the product development cycle was shortened.

  13. Numerical Analysis and Experimental Study of Hard Roofs in Fully Mechanized Mining Faces under Sleeve Fracturing

    Directory of Open Access Journals (Sweden)

    Zhitao Zheng

    2015-11-01

    Full Text Available Sudden falls of large-area hard roofs in a mined area release a large amount of elastic energy, generate dynamic loads, and cause disasters such as impact ground pressure and gas outbursts. To address these problems, in this study, the sleeve fracturing method (SFM was applied to weaken a hard roof. The numerical simulation software FLAC3D was used to develop three models based on an analysis of the SFM working mechanism. These models were applied to an analysis of the fracturing effects of various factors such as the borehole diameter, hole spacing, and sleeve pressure. Finally, the results of a simulation were validated using experiments with similar models. Our research indicated the following: (1 The crack propagation directions in the models were affected by the maximum principal stress and hole spacing. When the borehole diameter was fixed, the fracturing pressure increased with increasing hole spacing. In contrast, when the fracturing pressure was fixed, the fracturing range increased with increasing borehole diameter; (2 The most ideal fracturing effect was found at a fracturing pressure of 17.6 MPa in the model with a borehole diameter of 40 mm and hole spacing of 400 mm. The results showed that it is possible to regulate the falls of hard roofs using the SFM. This research may provide a theoretical basis for controlling hard roofs in mining.

  14. Mechanical behavior of pre tensioned metallic sleeves for pipeline repair; Comportamento mecanico de luvas metalicas pre tensionadas para reparo de dutos terrestres

    Energy Technology Data Exchange (ETDEWEB)

    Meniconi, Luiz C.M.; Paes, Marcelo T. Piza [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil). Centro de Pesquisas; Frainer, Vitor [Rio Grande do Sul Univ., Porto Alegre, RS (Brazil). Dept. de Metalurgia. Lab. de Metalurgia Fisica (LAMEF); Souza Filho, Byron G. de [PETROBRAS Transportes S.A. (TRANSPETRO), Rio de Janeiro, RJ (Brazil); Patricio, Wagner [Foxoil do Brasil Ltda., Macae, RJ (Brazil)

    2005-07-01

    Two different methods for pre-tensioning of metallic sleeves for pipeline repair were appraised: mechanic, by means of hydraulic jacks, and thermal, trough the use of oxyacetylene torches. Hydraulic jacks promote an 'in situ' forming of the sleeves, once they impose loads rather than displacements. There is no need of a perfect match between the external diameter of the pipe and the internal diameter of the sleeve. The thermal method, on the other hand, needs a tight fit between the sleeve and the pipe to assure that thermal expansion will turn into elastic deformation. Test specimens were built with four different defect types: crack, dent, gouged dent and thickness loss due to corrosion. The use of pre-tensioned sleeves led to failure pressures 39% above the hydro test pressure, at least. All the specimen failures occurred outside the reinforced area. (author)

  15. Prognostic significance of metastatic lymph nodes ratio in patients with gastric adenocarcinoma after curative gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Zhang Meiling; Wang Jian; Shi Wei; Chen Wenjiao; Li Wei; Shu Yongqian; Liu Ping

    2014-01-01

    Background We evaluated the impact of the number of metastatic lymph nodes and the metastatic lymph nodes ratio (the ratio between metastatic lymph nodes and total dissected lymph nodes,MLNR) in patients with gastric adenocaminoma following curative gastrectomy and also analyzed the relationship between the number of removed lymph nodes and prognosis in node-negative gastric cancer.Methods From January 2005 to December 2010,1 390 patients who were diagnosed with gastric adenocarcinoma and underwent curative gastrectomy were included.In particular,lymph node metastasis was not present in 515 patients.The number of metastatic lymph nodes and the metastatic lymph nodes ratio were selected for univariate and multivariate analyses to evaluate their influences on the disease outcome.The survival curve was presented according to the number of removed lymph nodes in node-negative gastric cancer using Kaplan-Meier plots.Results The overall 5-year survival rate was 54% in this group.Univariate analysis revealed that age category,macroscopic appearance,histological grade,tumor size,depth of primary tumor invasion,number of metastatic lymph nodes,metastatic lymph nodes ratio,tumor,nodes,metastasis-classification (TNM) stage and status of lymphovascular,and vessel invasion have significant impact on survival.The number of metastatic lymph nodes and the metastatic lymph nodes ratio both have significant impact on survival (P <0.001).However,in multivariate analyses,only the metastatic lymph nodes ratio was identified to be an independent prognostic factor (P <0.001).The number of removed lymph nodes in node-negative was a strong prognostic factor of survival,the more lymph nodes dissected,the better the survival.Conclusions The metastatic lymph nodes ratio has more significant prognostic value for survival in patients with gastric cancer following curative gastrectomy than the number of metastatic lymph nodes.The number of removed lymph nodes miaht be an important

  16. Quality of life of patients with carcinoma of stomach after radical gastrectomy%胃癌根治术后患者生活质量评价

    Institute of Scientific and Technical Information of China (English)

    李健; 马骏; 张晓云; 周璐

    2003-01-01

    @@ INTRODUCTION The radical gastrectomy gives a significant prolongation of survival for patients with gastric cancer.But the operation can cause weigh loss,malabsorption,disturbed eating habits, and psychological disturbances.In this study,food tolerance,body-weigh and performance status were determined in patients after radical gastrectomy for carcinoma.The purpose of the study is to evaluate the extent of gastric resection to assess their impact on quality of life(QOL).

  17. Study on grout-filled coupling steel sleeve. Part 1. Basic characteristics; Kokan sleeve wo mochiita grout juten shiki tekkin tsugite ni kansuru kenkyu. 2. Kisoteki seino

    Energy Technology Data Exchange (ETDEWEB)

    Takeda, K.; Shimizu, T.; Hayashi, Y.; Sato, Y. [Okumura Corp., Osaka (Japan)

    1994-11-15

    With an objective to establish a design technology on a grout-filled bar-reinforced joint consisted of a sleeve made of electric resistance welded steel tube and grout, discussions were given on the effects of different factors on the joint performance. The factors discussed include the kinds of grout (cement paste and mortar), reinforcing bar settlement length, and reinforcing bar quality. Increase in the grout strength causes the joint strength and rigidity to increase. To obtain the strength and rigidity equivalent to those in the reinforcing bars in the base material, the compaction strength required in the grout for the case of SB400 class reinforcing bars is 900 kgf/cm{sup 2}. A longer settlement length may increase the joint strength and rigidity, but its effect on tenacity is not clear. Increased grout strength can improve the tenacity. The maximum deposition stress increases in proportion with the compaction strength of the grout in any of the reinforcing bar unyielding positions and the yield occurring positions. The experiment resulted in estimating the following three fracture modes: a fracture mode with reinforcing bar slipping out without yield, a fracture mode with a reinforcing bar slipping out after yield, and a reinforcing bar tensile fracture mode. 7 refs., 7 figs., 2 tabs.

  18. 1例Prader-Willi综合征行腹腔镜袖状胃减容术患儿的护理%Nursing care of a child with Prader-Willi Syndrome managed with laparoscopic sleeve gastrectomy

    Institute of Scientific and Technical Information of China (English)

    高蔚; 顾莺; 罗飞宏; 施琼

    2012-01-01

    总结1例Prader-Willi综合征患儿行腹腔镜袖状胃减容术的围术期护理.护理要点包括充分的各项术前准备,心理护理和体质量控制;术后严密的病情观察,做好皮肤及切口护理,尤其是加强饮食控制,做好出院宣教及定期随访.患儿恢复顺利,术后24 d康复出院.

  19. Traumatic Neuroma around the Celiac Trunk after Gastrectomy Mimicking a Nodal Metastasis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jung Hyeok; Ryu, Seung Wan; Kang, Yu Na [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2007-06-15

    Traumatic neuroma is a well-known disorder that occurs after trauma or surgery involving the peripheral nerve and develops from a nonneoplastic proliferation of the proximal end of a severed, partially transected, or injured nerve. However, in the abdomen, traumatic neuromas have been sporadically reported to occur in the bile duct. We present here a case of traumatic neuroma around the celiac trunk after gastrectomy that mimicks a nodal metastasis. In conclusion, the imaging finding of traumatic neuroma around the celiac trunk was a homogeneous hypovascular mass without narrowing or irregularity of encased arteries and without increased uptake on PET-CT. Although from a clinical standpoint, establishing an accurate preoperative diagnosis is difficult to perform, the presence of a traumatic neuroma should be included in the differential diagnosis of a mass around the celiac trunk in a patient that has undergone celiac nodal dissection.

  20. [A case of partial hepatectomy and gastrectomy for hepatocellular carcinoma with direct invasion to the stomach].

    Science.gov (United States)

    Yoshida, Yuta; Murakami, Masahiro; Shimizu, Junzo; Kawada, Masahiro; Yasuyama, Akinobu; Yoshikawa, Yukihiro; Watase, Chikashi; Nishigaki, Takahiko; Kim, Ho Min; Hitora, Toshiki; Oda, Naofumi; Hirota, Masaki; Yoshikawa, Masato; Morishima, Hirotaka; Ikenaga, Masakazu; Mikata, Shoki; Matsunami, Nobuteru; Hasegawa, Junichi

    2014-11-01

    An 81-year-old man treated with chronic hepatitis C virus (HCV)-related hepatitis and hepatocellular carcinoma (HCC) was diagnosed in 2010 with HCC recurrence (subclass S2) on computed tomography (CT). He refused surgery and was followed up without treatment. In 2012, he was admitted to our hospital because of hematemesis. Gastrointestinal endoscopy revealed a large tumor in the upper gastric corpus, and pathological examination of the tumor revealed HCC; hence, we diagnosed the patient with direct HCC invasion to the stomach. Although active bleeding from the tumor was controlled, he experienced repeated episodes of hematemesis, and the tumor increased in size. Therefore, partial hepatectomy and gastrectomy were performed. It was confirmed that the tumor invaded the stomach wall. Although surgery was effective for gastrointestinal bleeding caused by HCC invasion, the patient died 12 months after surgery because of multiple liver metastases and exacerbated liver failure.

  1. When Eastern Surgeons Meet Western Patients: A Pilot Study of Gastrectomy with Lymphadenectomy in Caucasian Patients at a Single Korean Institute.

    Science.gov (United States)

    Nakagawa, Masatoshi; Choi, Yoon Young; An, Ji Yeong; Seo, Sang Hyuk; Shin, Hyun Beak; Bang, Hui Jae; Li, Shuangxi; Kim, Hyung Il; Cheong, Jae Ho; Hyung, Woo Jin; Noh, Sung Hoon

    2016-09-01

    East Asian surgeons generally report lower morbidity and mortality rates for gastrectomy with D2 lymphadenectomy than do surgeons in Western countries; however, the disparity remains unexplained. The aim of this article was to determine the feasibility and safety regarding cases in which East Asian surgeons perform such procedures in Caucasian patients (CPs). Twelve CPs underwent gastrectomy with lymphadenectomy for gastric cancer at Yonsei University Severance Hospital, Seoul, Korea between June 2011 and April 2014. Procedures performed included total gastrectomy (7 of 12, 58%), distal gastrectomy (4 of 12, 33%), and completion total gastrectomy (1 of 12, 8%). Nine patients (75%) underwent D2 lymphadenectomy, and D1+ lymphadenectomy was performed in three others (25%). In four patients (33%), combined resections were carried out. The median values of surgical parameters were as follows: operative time, 266.5 min (range, 120-586 min); estimated blood loss, 90 mL (range, 37-350 mL); retrieved lymph node count, 37.5 (range, 22-63); and postoperative hospital stay, 13.7 days (range, 5-63 days). No mortality was encountered, although two patients (17%) experienced complications (both Clavien-Dindo classification grade IIIa anastomotic leakages), which were successfully managed by conservative treatment. In the hands of East Asian surgeons, mortality and short-term morbidity appears to be acceptably low in CPs subjected to gastrectomy with lymphadenectomy for gastric cancer. PMID:27401666

  2. Roux-en-Y reconstruction does not require gastric decompression after radical distal gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Cheng-Jueng Chen; Tsang-Pai Liu; Jyh-Cherng Yu; Sheng-Der Hsua; Tsai-Yuan Hsieh; Heng-Cheng Chu; Chung-Bao Hsieh; Teng-Wei Chen; De-Chuan Chan

    2012-01-01

    AIM: To determine whether routine nasogastric (NG) decompression benefitted patients undergoing radical gastric surgery.METHODS: Between January 1998 and December 2008, 519 patients who underwent distal gastrectomy for gastric cancer were retrospectively divided into 2 time-period cohorts; those treated with Billroth Ⅱ (BⅡ) reconstruction in the first 6 years and those with Roux-en-Y (RY) reconstruction in the last 5 years. In the latter group, the patients were further divided into 2 subgroups; with and without nasogastric decompression.RESULTS: Postoperatively, there were no significant differences in the number of anastomotic leaks between the 3 groups. In the tubeless RY group, time to semi-liquid diet was significantly shorter than in the other 2 groups (4.4 d ± 1.4 d vs 7.2 d ± 1.3 d and 5.9 d ± 1.2 d, P = 0.005). The length of postoperative stay was significantly increased in patients with BⅡ reconstruction compared with patients with RY reconstruction with/without NG decompression (15.4 d ± 4.3 d in BⅡgroup vs 12.6 d ± 3.1 d in decompressed RY and 11.4 d ± 3.4 d in the tubeless RY group, P = 0.035). The postoperative pneumonia rate was lowest in the tubeless group and highest in the BⅡ group (1.4% vs 4.6%, P = 0.01). Severe sore throat was noted in 59 (20.7%) members of the BⅡ group, 18 (17.4%) members of the decompressed RY group and 6 (4.2%) members of the tubeless RY group. Fewer patients in the tubeless group complained of severe sore throat (P = 0.001).CONCLUSION: This study provides support for abandoning routine NG decompression in patients undergoing subtotal gastrectomy with Roux-en-Y gastrojejunostomy.

  3. Progression of remnant gastric cancer is associated with duration of follow-up following distal gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Shuhei Komatsu; Yoshiaki Kuriu; Masayoshi Nakanishi; Hitoshi Fujiwara; Toshiya Ochiai; Yukihito Kokuba; Eigo Otsuji; Daisuke Ichikawa; , Kazuma Okamoto; Daito Ikoma; Masahiro Tsujiura; Yukihisa Nishimura; Yasutoshi Murayama; Atsushi Shiozaki; Hisashi Ikoma

    2012-01-01

    AIM:To re-evaluate the recent clinicopathological features of remnant gastric cancer (RGC) and to develop desirable surveillance programs.METHOIDS:Between 1997 and 2008,1149 patients underwent gastrectomy for gastric cancer at the Department of Digestive Surgery,Kyoto Prefectural University of Medicine,Japan.Of these,33 patients underwent gastrectomy with lymphadenectomy for RGC.Regarding the initial gastric disease,there were 19 patients with benign disease and 14 patients with gastric cancer.The hospital records of these patients were reviewed retrospectively.RESULTS:Concerning the initial gastric disease,the RGC group following gastric cancer had a shorter interval [P < 0.05; gastric cancer vs benign disease:12 (2-22) vs 30 (4-51) years] and were more frequently reconstructed by Billroth- I procedure than those following benign lesions (P < 0.001).Regarding reconstruction,RGC following Billroth-Ⅱ reconstruction showed a longer interval between surgical procedures [P < 0.001; Billroth- 11 vs Billroth- Ⅰ:32 (5-51) vs 12 (2-36) years] and tumors were more frequently associated with benign disease (P < 0.001) than those following Billroth- I reconstruction.In tumor location of RGC,after Billroth- I reconstruction,RGC occurred more frequently near the suture line and remnant gastric wall.After Billroth- Ⅱ reconstruction,RGC occurred more frequently at the anastomotic site.The duration of followup was significantly associated with the stage of RGC (P < 0.05).Patients diagnosed with early stage RGC such as stage I -Ⅱ tended to have been followed up almost every second year.CONCLUSION:Meticulous follow-up examination and early detection of RGC might lead to a better prognosis.Based on the initial gastric disease and the procedure of reconstruction,an appropriate follow-up interval and programs might enable early detection of RGC.

  4. CT-guided 125I Radioactive Seed Implantation on Regional Lymph Node Metastasis after Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Shi Liangrong; Wu Jun; Jiang Jingting; Wu Changping

    2013-01-01

    Objective:To evaluate the safety and short-term effect of CT-guided 125I radioactive seed implantation on regional lymph node metastasis after gastrectomy. Methods:Twenty-three patients with regional lymph node metastasis after gastrectomy received CT-guided 125I radioactive seed implantation from June, 2007 to July, 2011 in our hospital. The overall activity and amount of radioactive seeds were calculated by simulating source distribution of radioactive seed implantation plan system before operation. 125I seeds were implanted under the guidance of CT. Effective rate was evaluated according to RECIST criterion, 1, 2 and 3 years of survival rates were calculated by life table method, the effect of relative factors on survival was tested by univariate COX model, and the survival differences between subgroups were compared to draw survival curve by log-rank method. Additionally, systemic therapies were given to 20 patients based on lfuorouracil drugs. Results:No severe complications was observed in all study subjects with 14 complete remission (60.9%), 5 particle remission (21.7%) and 4 progressive diseases (17.4%), while 1, 2 and 3 years of survival rates as well as median survival time being (87±7)%,(47±11)%, (13±9)% and (22.1±5.1) months, respectively. Univariate COX analysis showed that the maximum diameter of tumor could badly inlfuence the prognosis (χ2=9.752, P=0.002), and the subgroups analysis relieved the signiifcant difference (χ2=5.828, P=0.016, log-rank test) with 3 cm being the cut-off value. Conclusion:CT-guided 125I radioactive seed implantation has high local control rate with small trauma and slight complications.

  5. Biological conduit small gap sleeve bridging method for peripheral nerve injury: regeneration law of nerve fibers in the conduit

    Directory of Open Access Journals (Sweden)

    Pei-xun Zhang

    2015-01-01

    Full Text Available The clinical effects of 2-mm small gap sleeve bridging of the biological conduit to repair peripheral nerve injury are better than in the traditional epineurium suture, so it is possible to replace the epineurium suture in the treatment of peripheral nerve injury. This study sought to identify the regeneration law of nerve fibers in the biological conduit. A nerve regeneration chamber was constructed in models of sciatic nerve injury using 2-mm small gap sleeve bridging of a biodegradable biological conduit. The results showed that the biological conduit had good histocompatibility. Tissue and cell apoptosis in the conduit apparently lessened, and regenerating nerve fibers were common. The degeneration regeneration law of Schwann cells and axons in the conduit was quite different from that in traditional epineurium suture. During the prime period for nerve fiber regeneration (2-8 weeks, the number of Schwann cells and nerve fibers was higher in both proximal and distal ends, and the effects of the small gap sleeve bridging method were better than those of the traditional epineurium suture. The above results provide an objective and reliable theoretical basis for the clinical application of the biological conduit small gap sleeve bridging method to repair peripheral nerve injury.

  6. Biological conduit small gap sleeve bridging method for peripheral nerve injury:regeneration law of nerve ifbers in the conduit

    Institute of Scientific and Technical Information of China (English)

    Pei-xun Zhang; Li-ya A; Yu-hui Kou; Xiao-feng Yin; Feng Xue#; Na Han; Tian-bing Wang; Bao-guo Jiang

    2015-01-01

    The clinical effects of 2-mm small gap sleeve bridging of the biological conduit to repair periph-eral nerve injury are better than in the traditional epineurium suture, so it is possible to replace the epineurium suture in the treatment of peripheral nerve injury. This study sought to identify the regeneration law of nerve fibers in the biological conduit. A nerve regeneration chamber was constructed in models of sciatic nerve injury using 2-mm small gap sleeve bridging of a biodegradable biological conduit. The results showed that the biological conduit had good his-tocompatibility. Tissue and cell apoptosis in the conduit apparently lessened, and regenerating nerve ifbers were common. The degeneration regeneration law of Schwann cells and axons in the conduit was quite different from that in traditional epineurium suture. During the prime period for nerve fiber regeneration (2–8 weeks), the number of Schwann cells and nerve fibers was higher in both proximal and distal ends, and the effects of the small gap sleeve bridging method were better than those of the traditional epineurium suture. The above results provide an objec-tive and reliable theoretical basis for the clinical application of the biological conduit small gap sleeve bridging method to repair peripheral nerve injury.

  7. Behandling med duodenal-jejunal bypass-sleeve ved svær overvægt

    DEFF Research Database (Denmark)

    Rohde, Ulrich; Gylvin, Silas; Vilmann, Peter;

    2014-01-01

    Overweight and obesity are risk factors for several co-morbidities reducing life expectancy. Conservative treatment of obesity is generally ineffective in the long-term. Bariatric surgery has proven effective, but is associated with potential complications. Duodenal-jejunal bypass sleeve is a novel...

  8. Analysis and application of GEWI sleeve weld-ability (Material: C45)

    International Nuclear Information System (INIS)

    Welding may use two kinds of welding process of shielded metal arc welding and CO2 shielded arc welding between inner ring in nuclear island steel lining (material: P265GH) and GEWI sleeve (material:C45).CO2 shielded arc welding is often used because of higher welding efficiency, in particular, in condition of plan press, but quality can come into being some problems if we lack strict measures, for example welding procedure. Shielded metal arc welding control easier quality, but welding efficiency is lower. Comparing and analyzing Weld-ability of C45(Medium carbon Quenched and Tempered Steel.) between of shielded metal arc welding and CO2 shielded arc welding, suggest to use shielded metal arc welding in project practice, and control strict welding procedure measure of pre-heating treatment and Post-heating. (authors)

  9. Application of modern calculation and design methods for bucket wheel sleeve shafts

    Energy Technology Data Exchange (ETDEWEB)

    Moeser, H. (VEB Schwermaschinenbau Lauchhammerwerk, Lauchhammer-Ost (German Democratic Republic))

    1989-01-01

    Explains design of the bucket wheel sleeve shaft for the large SRs 6,300 bucket wheel excavator, built by TAKRAF, GDR. The excavator has a production capacity of 14,500 m{sup 3}/h and a bucket wheel diameter of 17 m. The bucket wheel shaft is 7 m long and weighs 33 t. A scheme of the shaft is provided. The design was developed by computer calculations with the ROSCHA program system of the Dresden Technical University. Shaft groove geometry was determined with the ALPHA program. The shaft was welded from segments that fulfilled requirements of the TGL 19 340 industrial standard. Measurements of load on this bucket wheel shaft and assessment of service life have been made during excavator operations in brown coal surface mines. 5 refs.

  10. Late results of mucosal proctectomy and colo-anal sleeve anastomosis for chronic irradiation rectal injury

    International Nuclear Information System (INIS)

    Ten patients with severe chronic irradiation injury to the rectum were treated by mucosal proctectomy and colo-anal sleeve anastomosis. The indications were: recurrent rectal bleeding (five), stricture (three), fistula (one) and intractable pain (one). Overall follow-up has ranged from 8 to 77 months (mean 40 months). In the present survivors (n=7) the follow-up ranges from 18 to 77 months (mean 52 months). Six patients have been followed up for more than 3 years and four for more than 5 years. There was no operative mortality. Three anastomotic strictures occurred but the protecting stoma could be closed in all but one patient. Continence was acceptable although urgency and frequency of defaecation were troublesome symptoms. The operation is recommended for life-threatening, haemorrhagic chronic irradiation injury to the rectum. (author)

  11. Late onset of chylous ascites following distal gastrectomy with D1(+ dissection for gastric cancer: A case report

    Directory of Open Access Journals (Sweden)

    Hüseyin Çiyiltepe

    2015-12-01

    Full Text Available Chyloperitoneum is the accumulation of lymphatic fluid in the peritoneal cavity. Chylous ascites can occur if it is not recognized during surgery. The incidence of chylous ascites after oncological surgery was approximately 7.4% however, the incidence of lymphorrhea after radical gastrectomy for gastric cancer is so low. Extensive lymph node dissection leads to a higher incidence of lymphorrhea. There have been few cases associated with D1 dissection In most patients conservative treatment is recommended that includes paracentesis, total parenteral nutrition (TPN, a medium chain triglyceride (MCT based diet, and somatostatin. Surgery is the last choice only when conservative treatment fails. In this case we aimed to present a late onset of chylous ascites after subtotal gastrectomy and D1+ dissection that was treated with percutaneous drainage and conservative management.

  12. Effects of Different Operative Procedures on the Digestive and Nutritional Status of Patients Treated with a Gastrectomy for Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    Han Liang; Xishan Hao

    2006-01-01

    Postgastrectomy syndromes evoked by the loss of several gastric functions after total or subtotal gastrectomy are very common. Different kinds of reconstruction have been developed to overcome the problem. Patients with preservation of a duodenal passage and jejunal interposition with or without a pouch show a better quality of life and minimal symptoms postoperatively. A jejunal interposition with or without a pouch after proximal or distal subtotal gastrictomy seems to improve the nutritional condition and quality of life. The prognostic nutritional index (PNI), Visick score, Spitzer index and the European Organization for Research and Treatment of Cancer (EORTC) questionnaire (QLQ-C30) are available to evaluate the quality of life and nutritional status after gastrectomy.

  13. Fast-track surgery protocol in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer: a randomized controlled trial

    OpenAIRE

    Liu G; Jian F; Wang X; Chen L

    2016-01-01

    Guozheng Liu,1 Fengguo Jian,2 Xiuqin Wang,2 Lin Chen1 1Department of General Surgery, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Second Department of General Surgery, Changyi People’s Hospital, Shandong, People’s Republic of China Aim: To study the efficacy of the fast-track surgery (FTS) program combined with laparoscopic radical gastrectomy for elderly gastric cancer (GC) patients.Methods: Eighty-four elderly patients diagnosed with GC between Se...

  14. Fast-track surgery protocol in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer: a randomized controlled trial

    OpenAIRE

    Chen, Linpayi

    2016-01-01

    Guozheng Liu,1 Fengguo Jian,2 Xiuqin Wang,2 Lin Chen1 1Department of General Surgery, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Second Department of General Surgery, Changyi People’s Hospital, Shandong, People’s Republic of China Aim: To study the efficacy of the fast-track surgery (FTS) program combined with laparoscopic radical gastrectomy for elderly gastric cancer (GC) patients.Methods: Eighty-four elderly patients diagnosed with G...

  15. The Quality of Life of Gastric Cancer Patients with and without Duodenal Passage Reconstructions after Total Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Dongsheng Li; Huimian Xu

    2005-01-01

    OBJECTIVE To evaluate the Quality of Life of the patients who received a total gastrectomy with different kinds of reconstruction methods.METHODS Patients who received a total gastrectomy between May 1999 to May 2003 were followed-up via questionnaires. Fifty-nine who were alive more than 2 years with no sigh of recurrence were enrolled in this study. The patients were divided into 2 groups as follows: a group treated with reconstruction with a duodenal passage after total gastrectomy (gastric substitute, GS); and a group receiving reconstruction without duodenal passage after total gastrectomy (Jejenal pouch, JP). Follow-up feedback data of 14 items from the patients were analyzed, comparing the Quality of Life (QOL) between the 2 groups.RESULTS Six months after operation, the most common symptoms of all patients were reflux and loss of body weight, but there was no statistically significant differences in the 14 items related to the special post-operation symptoms between the 2 groups. At 12 months after the operations,there were significant differences between the 2 groups in body weight (P=0.01), eating time (P=0.034<0.05), and frequency of food intake (P=0.040<0.05); At 24 months after the operations, the only difference between the 2 groups was body weight gain (P=0.025<0.05). The JP group was better than the GS group.CONCLUSION The JP reconstruction pattern is superior to a simple GS in gain of body weight, volume of food intake and frequency of food intake, soon after the operation.

  16. Percutaneous placement of self-expandable metallic stents in patients with obstructive janudice secondary to metastalic gastric cancer after gastrectomy

    International Nuclear Information System (INIS)

    To evaluate the outcomes of patients undergoing percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy. Fifty patients (mean age, 62.4 years; range, 27-86 years) who underwent percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy were included. The technical success rate, clinical success rate, complication rate, stent patency, patient survival and factors associated with stent patency were being evaluated. The median interval between the gastrectomy and stent placement was 23.1 months (range, 3.9-94.6 months). The 50 patients received a total of 65 stents without any major procedure-related complications. Technical success was achieved in all patients. The mean total serum bilirubin level, which had been 7.19 mg/dL ± 6.8 before stent insertion, decreased to 4.58 mg/dL ± 5.4 during the first week of follow-up (p < 0.001). Clinical success was achieved in 42 patients (84%). Percutaneous transhepatic biliary drainage catheters were removed from 45 patients (90%). Infectious complications were noted in two patients (4%), and stent malfunction occurred in seven patients (14%). The median stent patency was 233 ± 99 days, and the median patient survival was 179 ± 83 days. Total serum bilirubin level after stenting was an independent factor for stent patency (p = 0.009). Percutaneous transhepatic placement of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy is a technically feasible and clinically effective palliative procedure.

  17. Simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach

    OpenAIRE

    Zhu, Qian-Lin; Zheng, Min-Hua; Feng, Bo; Lu, Ai-Guo; Wang, Min-Liang; Li, Jian-Wen; HU, WEI-GUO; Zang, Lu; Mao, Zhi-Hai; Dong, Feng; Ma, Jun-Jun; Zong, Ya-ping

    2008-01-01

    Laparoscopic resection of rectal cancer or gastric cancer has been advocated for the benefits of a reduced morbidity, a shorter treatment time, and similar outcomes. However, simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach are rarely documented in literature. Endoscopic examination revealed a synchronous carcinoma of rectum and stomach in a 55-year-old male patient with rectal bleeding and epigastric discomfort. H...

  18. Percutaneous placement of self-expandable metallic stents in patients with obstructive janudice secondary to metastalic gastric cancer after gastrectomy

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Pyo [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Seo, In Ho; Yu, Jung Rim; Mok, Young Jae; Oh, Joo Hyeong [Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kwon, Se Hwan [Dept. of Radiology, Kyung Hee University Medical Center, Seoul (Korea, Republic of); Kim, Sam Soo [Dept. of Radiology, Kangwon National University College of Medicine, Chuncheon (Korea, Republic of); Kim, Seung Kwon [Division of Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (United States)

    2013-10-15

    To evaluate the outcomes of patients undergoing percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy. Fifty patients (mean age, 62.4 years; range, 27-86 years) who underwent percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy were included. The technical success rate, clinical success rate, complication rate, stent patency, patient survival and factors associated with stent patency were being evaluated. The median interval between the gastrectomy and stent placement was 23.1 months (range, 3.9-94.6 months). The 50 patients received a total of 65 stents without any major procedure-related complications. Technical success was achieved in all patients. The mean total serum bilirubin level, which had been 7.19 mg/dL ± 6.8 before stent insertion, decreased to 4.58 mg/dL ± 5.4 during the first week of follow-up (p < 0.001). Clinical success was achieved in 42 patients (84%). Percutaneous transhepatic biliary drainage catheters were removed from 45 patients (90%). Infectious complications were noted in two patients (4%), and stent malfunction occurred in seven patients (14%). The median stent patency was 233 ± 99 days, and the median patient survival was 179 ± 83 days. Total serum bilirubin level after stenting was an independent factor for stent patency (p = 0.009). Percutaneous transhepatic placement of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy is a technically feasible and clinically effective palliative procedure.

  19. [Effectiveness of chemoradiotherapy for a patient with local recurrence of advanced gastric cancer followed by curable gastrectomy].

    Science.gov (United States)

    Natsume, Soichiro; Iwasaki, Yoshiaki; Yajima, Kazuhito; Yuu, Ken; Oohinata, Ryouki; Ishiyama, Satoshi; Takahashi, Keiichi; Maeda, Yoshiharu

    2014-11-01

    We report here the effectiveness of chemoradiotherapy for a patient with local recurrence followed by curable gastrectomy. A 57-year-old man presented with a history of total gastrectomy with distal pancreatectomy and splenectomy, D2 lymphadenectomy, and Roux-en-Y reconstruction for advanced gastric cancer arising from the cardia. Esophageal intramural metastasis and lymph node metastasis around the right recurrent nerve were detected by chest-abdominal computed tomography and gastrointestinal endoscopy 27 months after the initial gastrectomy. Stable disease was achieved following 7 courses of chemotherapy using S-1 plus CDDP. Concurrent chemoradiotherapy including administration of S-1 and radiation of total 50 Gy (2 Gy/25 Fr) was selected for local tumor control. The patient was not able to eat solid food because of esophageal stenosis from regrowth of intramural metastasis of the esophagus 60 months after the chemotherapy. A WallFlex™ Duodenal Stent was placed to improve the dysphagia 67 months after chemotherapy. The patient died from recurrence of gastric cancer 69 months after completion of the initial chemotherapy and 2 months after the stent insertion.

  20. Manufacture and test of mechanical connections for ceramic heat exchanger tubes/ceramic sleeve-screw connection

    International Nuclear Information System (INIS)

    Goal of the project was the qualification of a mechanical connection for ceramic heat-exchanger tubes made from SiSiC. The tube ends with external screw threads are turned into a ceramic sleeve with internal threads. A flat sealing provides sufficient tightness. Tube compounds of approx. 4.7 m length were manufactured for a solar receiver test panel. In fall/winter 1987/88 the panel was successfully tested under realistic environmental and operational conditions up to 10000C air outlet temperature at the Plataforma Solar in Almeria/Spain, and the ceramic sleeve connection withstood all loads. The work was performed in completion of the German-Spanish Technology Program GAST (Gas-cooled Solar Tower Power Plant) in close cooperation with the companies MAN Technologie and Asinel. (orig.) With 8 refs., 1 tab., 14 figs

  1. Investigation of the interrelationship of the production operations of oil-well sucker-rod pump sleeves

    Energy Technology Data Exchange (ETDEWEB)

    Kurbanov, A.K.

    1987-03-01

    The authors present a process and a method for its control for the production of oil well rod pump sleeves. The method makes use of regression equations and correlation functions as implemented in a Minsk-32 computer for an online control and inspection system and guarantees the accuracy of various machining operations such as honing and boring as well as nitridation in achieving specified tolerances and size and straightness requirements.

  2. Comparative study of laparoscopic vs open gastrectomy in gastric cancer management

    Institute of Scientific and Technical Information of China (English)

    Giuseppe S Sica; Edoardo Iaculli; Livia Biancone; Sara Di Carlo; Rosa Scaramuzzo; Cristina Fiorani; Paolo Gentileschi; Achille L Gaspari

    2011-01-01

    AIM: To compare long-term results of gastric cancer patients undergoing laparoscopic and open gastrectomy in a single unit.METHODS: From February 2000 to September 2004, all patients with adenocarcinoma of the stomach were assessed to entry in this longitudinal prospective non-randomized trial. Primary endpoint was cancer-related survival and secondary endpoints were overall survival, evaluation of surgical complications and mortality.RESULTS: Fifty-eight patients were enrolled. Forty-seven patients were followed-up (range 11-103, median 38 mo). Four patients were lost at follow up. Twenty-two patients underwent a laparoscopic gastric surgery (LGS) and 25 had a standard open procedure (OGS). No statistical difference was found between the two groups in terms of 5 years cancer-related mortality rate (50% vs 52%, P = 1), and 5 years overall mortality rate (54.5% vs 56%, P = 1). Accordingly, cancer-related and overall survival probability by Kaplan-Meier method showed comparable results (P = 0.81 and P = 0.83, respectively). We found no differences in surgical complications in the 2 groups. There was no conversion to open surgery in this series.CONCLUSION: LGS is as effective as OGS in the management of advanced gastric cancer. However LGS cannot be recommended routinely over OGS for the treatment of advanced gastric cancer.

  3. Nutritional risk index as a predictor of postoperative wound complications after gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Cheong Ah Oh; Dae Hoon Kim; Seung Jong Oh; Min Gew Choi; Jae Hyung Noh; Tae Sung Sohn; Jae Moon Bae; Sung Kim

    2012-01-01

    AIM:To investigate the correlation between the nutritional risk index (NRI) and postoperative wound complications.METHODS:From January 2008 through June 2008,669 patients who underwent curative gastrectomy for gastric cancer were included in a retrospective study.Medical records of consecutive patients were collected and analyzed to determine postoperative wound complication rates.The NRI was assessed on the fifth postoperative day and other possible risk factors for the incidence of wound complications were analyzed to identify the factors affecting postoperative wound complications.Patients with other postoperative complications were excluded from the study.RESULTS:On the 5th postoperative day,the NRI showed a malnutrition rate of 84.6% among postoperative patients.However,postoperative wound complications occurred in only 66/669 (9.86%) patients.Of the patients with wound complications,62/66 (94%)belonged to the malnourished group (NRI < 97.5),and 4/66 (6%) patients to the non-malnourished group (NRI ≥ 97.5).The only factor correlated with wound complications was the NRI on the 5th postoperative day (odds ratio of NRI ≥ 97.5 vs NRI < 97.5:0.653; 95%confidence interval:0.326-0.974; P =0.014) according to univariate analysis as well as multivariate analysis.CONCLUSION:This study suggests that malnutrition immediately after surgery may play a significant role in the development of wound complications.

  4. Evaluation of gallbladder motility in patients following total gastrectomy (Roux-en-Y) by infusion cholescintigraphy

    International Nuclear Information System (INIS)

    Background: The aim of the study is to evaluate gallbladder (GB) motor function, by infusion cholescintigraphy, in patients after total gastrectomy (Roux-en-Y) with expected disturbances in the physiological regulation of biliary tract motility. Methods: The study was done in 10 controls, as well as in 12 patients early (less than 2 months) and in 14 late (6 months-2 years) after surgery. Anterior abdominal imaging by gamma camera and computer acquisition was performed during three-hours infusion of 150 MBq, preceded by the loading dose of 50 MBq of 99mTc-EHIDA in bolus injection. The test meal stimulation was done in the 120th min of the study. GB TA curve was obtained and five parameters of GB motility were analysed: durations of filling (ascending) and emptying (descending) phases, filling and emptying rate ratio and ejection fraction and rate. Results: Our results have shown that in the early period after the operation GB filling is prolonged and emptying impaired, while after several months GB motor function is normalised. Conclusions: It can be concluded that the infusion cholescintigraphy is potentially useful in patients after such surgery to decide on the specific treatment introduction in order to prevent GB calculosis and other complications. (author)

  5. Chronological Changes of Quality of Life in Long-Term Survivors after Gastrectomy for Gastric Cancer

    Science.gov (United States)

    Yu, Wansik; Park, Ki Bum; Chung, Ho Young; Kwon, Oh Kyoung; Lee, Seung Soo

    2016-01-01

    Purpose A few studies have prospectively evaluated changes in quality of life (QoL) after surgery in short-term survivors; however, no prospective study has evaluated the longitudinal changes in QoL in long-terms survivors. We prospectively evaluated the chronological changes in QoL after a gastrectomy over a 5-year postoperative period in a large group of patients. Materials and Methods QoL data from the European Organization for Research and Treatment of Cancer QLQ-C30 and the QLQ-STO22 questionnaires were obtained from 254 patients who completed the entire series of QoL assessments preoperatively and at 1, 2, 3, 4, and 5 years after surgery. Results There was no statistically significant change in global health status/QoL during the 5-year postoperative period. Decreases in QoL from upper gastrointestinal symptoms including diarrhea (p physical functioning (p physical functioning, role functioning, and body image. In addition, patients should be encouraged to preserve self-esteem and maintain social activity. PMID:27004956

  6. Distribution of fission products in graphite sleeves and blocks of the ninth and tenth OGL-1 fuel assemblies

    International Nuclear Information System (INIS)

    Distribution of fission products in graphite sleeves and blocks of the ninth and tenth OGL-1 fuel assemblies was measured by gamma spectrometry with lathe sectioning. The assemblies were loaded with HTGR fuel compacts, which had been produced by a scaled-up facility for the High Temperature Engineering Test Reactor (HTTR) being developed by JAERI; and they were irradiated in an in-pile gas loop, OGL-1. Fission products detected in the sleeves were 137Cs, 134Cs, 155Eu, 154Eu, 144Ce, 125Sb and 110mAg. The last nuclide, however, may have been produced by activation of a stable isotope, 109Ag, contained as impurity. Effective retention capability of the sleeve was observed for 155Eu, 154Eu, 144Ce and 125Sb; while, not for 137Cs and 134Cs. Concentration of 137Cs in the graphite blocks was markedly higher at the downstream side than at the upstream side of the coolant. This was ascribed to migration of the nuclide with the coolant flow and its subsequent sorption on the surface of the block. (author)

  7. Fracture of a titanium sleeve-encased third-generation ceramic liner in a modern THA.

    Science.gov (United States)

    Chotai, Pranit N; Su, Edwin P

    2011-10-01

    Due to their excellent tribology, ceramics are increasingly used for total hip arthroplasty (THA) in young patients. Fracture rates for contemporary ceramics range from 0% to 0.004%. Recently, ceramic liners are encased in a titanium sleeve to further decrease the chances of fracture. We encountered 1 case of a metal-encased acetabular liner fracture in a ceramic-on-ceramic articulation in a series of 764 hips. Our literature review revealed no reports of metal-encased ceramic liner fracture. A 60-year-old woman presented 27 months after a bilateral ceramic-on-ceramic THA. She reported mechanical grinding and clicking from the left hip on extension. There was no history of trauma or fall. Examination revealed a nonantalgic gait and audible-palpable crepitations on the left hip. Range of motion of the left hip was intact with no subluxation. Radiographs revealed fractured ceramic insert and an excessively anteverted socket on the left side. Intraoperative findings revealed gross impingement in the form of indentation of the metal femoral neck against the elevated metal rim encasing the liner. Revision THA was performed using an uncemented polyethylene liner while retaining the well-fixed cup and stem. The Harris Hip Score at 4.5-year follow-up was 100, with no evidence of osteolysis or polyethylene wear.

  8. 胃癌合并2型糖尿病患者行腹腔镜与开腹全胃切除术的疗效比较%Curative effect of laparoscopic gastrectomy and total gastrectomy for patients with gastric cancer accompanying type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    滕达; 李松岩; 宁宁; 杜晓辉

    2013-01-01

    Objective To find out the best procedure for patients with gastric cancer accompanying type 2 diabetes mellitus (DM) by comparing the curative effect of laparoscopic gastrectomy and laparoscopic total gastrectomy. Methods Clinical data about 76 patients with gastric cancer accompanying DM admitted to our hospital from June 2008 to June 2010 were retrospectively analyzed. The patients were divided into laproscopic gastrectomy group (n=38) and laproscopic total gastrectomy group (n=38). The curative effect of the two procedures was compared. Results The effective rate was 73.7%and 57.9%for the laparoscopic total gastrectomy group and laparoscopic gastrectomy group, respectively (P<0.05). The incision size was smaller, blood loss was less, the postoperative anal exhaust time and feeding time were shorter, the number of white blood cells and neutrophils was lower in laparoscopic total gastrectomy group than in laparoscopic gastrectomy group (P <0.05). Conclusion The curative effect of laparoscopic total gastrectomy is better than that of laparoscopic gastrectomy for patients with gastric cancer accompanying type 2 DM.%  目的比较腹腔镜和开腹手术治疗胃癌合并2型糖尿病患者的临床疗效,寻求最佳的治疗方法.方法以解放军总医院2008年6月-2010年6月治疗的76例胃癌合并糖尿病患者为研究对象,对其临床资料进行回顾性分析.开腹手术组(open surgery,OS)38例;腹腔镜手术组(laparoscopic surgery,LAP)38例.对两组手术方法及临床疗效等进行比较.结果腹腔镜手术组有效率为73.7%,开腹手术组为57.9%,差异有统计学意义(P<0.05);在切口大小、出血量、术后肛门排气时间、进食时间及白细胞和中性粒细胞计数等数据进行比较,腹腔镜手术组均优于开腹组(P<0.05).结论在胃癌合并2型糖尿病患者的治疗中,腹腔镜全胃切除术较开腹手术疗效显著.

  9. A possible variant of Bouveret's syndrome presenting as a duodenal stump obstruction by a gallstone after Roux-en-Y gastrectomy: a case report

    Directory of Open Access Journals (Sweden)

    Mittal Shruti

    2009-05-01

    Full Text Available Abstract Introduction Bouveret's syndrome is characterized by gastric outlet obstruction due to a gallstone in the duodenum, usually in association with a cholecystoduodenal fistula. Case presentation We report the case of a 69-year-old Caucasian man who developed duodenal stump obstruction due to an impacted gallstone after having previously undergone Roux-en-Y gastrectomy. Conclusions Duodenal stump obstruction after Roux-en-Y gastrectomy is rare, and may be difficult to manage. Patients who present with upper gastrointestinal or pancreatobiliary pathology after previous gastric surgery should be managed in centres with the availability of appropriate endoscopic and surgical experience.

  10. Early rehabilitation after surgery program versus conventional care during perioperative period in patients undergoing laparoscopic assisted total gastrectomy

    Directory of Open Access Journals (Sweden)

    Manash Ranjan Sahoo

    2014-01-01

    Full Text Available Objective: To evaluate the safety and efficacy of early rehabilitation after surgery program (ERAS in patients undergoing laparoscopic assisted total gastrectomy. Materials And Methods: This is a study where 47 patients who are undergoing lap assisted total gastrectomy are selected. Twenty-two (n = 22 patients received enhanced recovery programme (ERAS management and rest twenty-five (n = 25 conventional management during the perioperative period. The length of postoperative hospital stay, time to passage of first flatus, intraoperative and postoperative complications, readmission rate and 30 day mortality is compared. Serum levels of C-reactive protein pre-operatively and also on post-op day 1 and 3 are compared. Results: Postoperative hospital stay is shorter in ERAS group (78 ± 26 h when compared to conventional group (140 ± 28 h. ERAS group passed flatus earlier than conventional group (37 ± 9 h vs. 74 ± 16 h. There is no significant difference in complications between the two groups. Serum levels of CRP are significantly low in ERAS group in comparison to conventional group. [d1 (52.40 ± 10.43 g/L vs. (73.07 ± 19.32 g/L, d3 (126.10 ± 18.62 g/L vs. (160.72 ± 26.18 g/L]. Conclusion: ERAS in lap-assisted total gastrectomy is safe, feasible and efficient and it can ameliorate post-operative stress and accelerate postoperative rehabilitation in patients with gastric cancer. Short term follow up results are encouraging but we need long term studies to know its long term benefits.

  11. Clinical significance of No. 10 and 11 lymph nodes posterior to the splenic vessel in D2 radical total gastrectomy

    Science.gov (United States)

    Wang, Wei; Xiong, Wenjun; Liu, Zhiwei; Luo, Lijie; Zheng, Yansheng; Tan, Ping; Diao, Dechang; Zou, Liaonan; Wan, Jin

    2016-01-01

    Abstract D2 lymphadenectomy is widely performed for advanced proximal gastric cancer, but complete dissection of No. 10 and 11 lymph nodes (LNs) is technically challenging, especially for those posterior to the splenic vessel. This study aimed to investigate the clinical significance of removing No. 10 and 11 LNs posterior to the splenic vessel in radical total gastrectomy. Between January 2013 and February 2015, 53 patients who underwent spleen-preserving D2 radical total gastrectomy were enrolled. While dissecting No. 10 and 11 LNs, we divided them into 2 parts, namely LNs anterosuperior and posterior to the splenic vessel, and the pathological data were reviewed. Sixteen patients underwent laparoscopy and 37 underwent laparotomy. No mortality was recorded. According to the pathological results, the TNM stages of the tumor were IIA in 11 patients (20.8%), IIB in 5 (9.4%), IIIA in 7 (13.2%), IIIB in 10 (18.9%), and IIIC in 20 (18.9%). The mean number of LNs retrieved was 30.3 ± 12.3. The sum of No. 10 and 11 LNs posterior to the splenic vessel was 59 and the mean number was 1.11 ± 1.47. One LN with metastasis was found in the special 59 regional LNs, and the metastasis rate was 1.9% (1/53). Concerning the low metastasis rate (1.9%) and difficult complete dissection of No. 10 and 11 LNs posterior to the splenic vessel, our initial analysis suggests that the rate of No. 10 and 11 LNs posterior to the splenic vessel metastasis was 1.9%, but further studies are needed to reveal its clinical significance in D2 radical total gastrectomy for advanced proximal gastric cancer. PMID:27512888

  12. The effects of a prophylactic knee brace and two neoprene knee sleeves on the performance of healthy athletes: a crossover randomized controlled trial.

    Science.gov (United States)

    Mortaza, Niyousha; Ebrahimi, Ismail; Jamshidi, Ali Ashraf; Abdollah, Vahid; Kamali, Mohammad; Abas, Wan Abu Bakar Wan; Osman, Noor Azuan Abu

    2012-01-01

    Knee injury is one of the major problems in sports medicine, and the use of prophylactic knee braces is an attempt to reduce the occurrence and/or severity of injuries to the knee joint ligament(s) without inhibiting knee mobility. The aim of the present study was to examine the effect of one recently designed prophylactic knee brace and two neoprene knee sleeves upon performance of healthy athletes. Thirty-one healthy male athletes (age = 21.2 ± 1.5) volunteered as participants to examine the effect of prophylactic knee brace/sleeves on performance using isokinetic and functional tests. All subjects were tested in four conditions in a random order: 1. nonbraced (control) 2. using a neoprene knee sleeve 3. using a knee sleeve with four bilateral metal supports and 4. using a prophylactic knee brace. The study design was a crossover, randomized, controlled trial. Subjects completed single leg vertical jump, cross-over hop, and the isokinetic knee flexion and extension (at 60, 180, 300°/sec). Data were collected from the above tests and analyzed for jump height, cross-over hop distance, peak torque to body weight ratio and average power, respectively. Comparisons of these variables in the four testing conditions revealed no statistically significant difference (p>0.05). The selected prophylactic brace/sleeves did not significantly inhibit athletic performance which might verify that their structure and design have caused no complication in the normal function of the knee joint. Moreover, it could be speculated that, if the brace or the sleeves had any limiting effect, our young healthy athletic subjects were well able to generate a mean peak torque large enough to overcome this possible restriction. Further studies are suggested to investigate the long term effect of these prophylactic knee brace and sleeves as well as their possible effect on the adjacent joints to the knee.

  13. The effects of a prophylactic knee brace and two neoprene knee sleeves on the performance of healthy athletes: a crossover randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Niyousha Mortaza

    Full Text Available Knee injury is one of the major problems in sports medicine, and the use of prophylactic knee braces is an attempt to reduce the occurrence and/or severity of injuries to the knee joint ligament(s without inhibiting knee mobility. The aim of the present study was to examine the effect of one recently designed prophylactic knee brace and two neoprene knee sleeves upon performance of healthy athletes. Thirty-one healthy male athletes (age = 21.2 ± 1.5 volunteered as participants to examine the effect of prophylactic knee brace/sleeves on performance using isokinetic and functional tests. All subjects were tested in four conditions in a random order: 1. nonbraced (control 2. using a neoprene knee sleeve 3. using a knee sleeve with four bilateral metal supports and 4. using a prophylactic knee brace. The study design was a crossover, randomized, controlled trial. Subjects completed single leg vertical jump, cross-over hop, and the isokinetic knee flexion and extension (at 60, 180, 300°/sec. Data were collected from the above tests and analyzed for jump height, cross-over hop distance, peak torque to body weight ratio and average power, respectively. Comparisons of these variables in the four testing conditions revealed no statistically significant difference (p>0.05. The selected prophylactic brace/sleeves did not significantly inhibit athletic performance which might verify that their structure and design have caused no complication in the normal function of the knee joint. Moreover, it could be speculated that, if the brace or the sleeves had any limiting effect, our young healthy athletic subjects were well able to generate a mean peak torque large enough to overcome this possible restriction. Further studies are suggested to investigate the long term effect of these prophylactic knee brace and sleeves as well as their possible effect on the adjacent joints to the knee.

  14. [A case of S-1/CDDP chemotherapy for inoperable advanced gastric cancer which led to gastrectomy with histological complete response].

    Science.gov (United States)

    Kobayashi, Kenji; Tanizaki, Keiko; Aoki, Taro; Takachi, Kou; Nishioka, Kiyonori; Matsumoto, Takashi; Komori, Takamichi; Chono, Teruhiro; Kato, Aya; Hyuga, Satoshi; Watanabe, Risa; Uemura, Yoshio

    2011-11-01

    As the treatment for inoperable advanced gastric cancer, S-1/CDDP combination therapy (SP chemotherapy) has become a standard treatment. In our hospital, a second course of chemotherapy was performed on an outpatient basis in order to improve a traditional QOL. In this case, it showed remarkable effects in 15 months after starting chemotherapy. Then gastrectomy was performed. Histological findings of the resected specimens confirmed pCR in all tumors. We report on progress of this case and explain about the ingenuity of SP chemotherapy.

  15. Is Gastrectomy-Induced High Turnover of Bone with Hyperosteoidosis and Increase of Mineralization a Typical Osteomalacia?

    OpenAIRE

    Takashi Ueyama; Yuta Yamamoto; Kazuki Ueda; Aiji Yajima; Yoshimasa Maeda; Yasunobu Yamashita; Takao Ito; Yoshihiro Tsuruo; Masao Ichinose

    2013-01-01

    Gastrectomy (GX) is thought to result in osteomalacia due to deficiencies in Vitamin D and Ca. Using a GX rat model, we showed that GX induced high turnover of bone with hyperosteoidosis, prominent increase of mineralization and increased mRNA expression of both osteoclast-derived tartrate-resistant acid phosphatase 5b and osteocalcin. The increased 1, 25(OH)2D3 level and unchanged PTH and calcitonin levels suggested that conventional bone and Ca metabolic pathways were not involved or change...

  16. Preventing prolonged post-operative ileus in gastric cancer patients undergoing gastrectomy and intra-peritoneal chemotherapy

    Institute of Scientific and Technical Information of China (English)

    De-Chuan Chan; Kuo-Liang Shen; Yao-Chi Liu; Cheng-Jueng Chen; Jyh-Cherng Yu; Heng-Cheng Chu; Fa-Chang Chen; Teng-Wei Chen; Huan-Fa Hsieh; Tzu-Ming Chang

    2005-01-01

    AIM: To assess the efficacy of metoclopramide (Met) for prevention of prolonged post-operative ileus in advanced gastric cancer patients undergoing D2 gastrectomy and intra-peritoneal chemotherapy (IPC).METHODS: Thirty-two advanced gastric cancer patients undergoing D2 gastrectomy and IPC were allocated to two groups. Sixteen patients received Met immediately after operation (group A), and 16 did not (group B). Another 16 patients who underwent D2 gastrectomy without IPC were enrolled as the control group (group C). All patients had received epidural pain control. The primary endpoints were time to first post-operative flatus and time until oral feeding with a soft diet without discomfort. Secondary endpoints were early complications during hospitalization.RESULTS: Gender, the type of resection, operating time,blood loss, tumor status and amount of narcotics were connparable in the three groups. However, the group C patients were older than those in groups A and B (67.5±17.7 vs 56.8±13.2, 57.5±11.7 years, P= 0.048). First bowel flatus occurred after 4.35±0.93 d in group A, 4.94±1.37 d in group B, and 4.71±1.22 d in group C (P>0.05). Oral feeding of a soft diet was tolerated 7.21±1.92 d after operation in group A, 10.15±2.17 d in group B, and 7.53±1.35 d in group C(groups A and C vsgroup B, P<0.05). There was no significant difference in respect to the first flatus among the three groups. However, the time of tolerating oral intake with soft food in groups A and C patients was significantly shorter than that in group B patients. Levels of C-reactive protein (CRP) were significantly lower in group C and there was a more prominent and prolonged response in CRP level in patients undergoing IPC. The incidence of post-operative complications was similar in the three groups except for prolonged post-operative ileus. There was no increased risk of anastomotic leakage in patients receiving Met.CONCLUSION: The results suggest that a combination of intravenous

  17. Total gastrectomy for rare refractory gastroparesis in patient with syringomyelia: A good impact on quality of life

    Directory of Open Access Journals (Sweden)

    Maurizio Zizzo

    2015-12-01

    We report a case of a 67-year-old woman with a history of pain in the back-lumbar spine and lower limbs, paresthesia and urinary incontinence. MRI revealed syringomyelia, extended from T3 to the medullary cone. Neurological picture was worsened by progressive and increasingly debilitating gastrointestinal symptoms refractory to dietary changes and medical treatment. Blood tests, gastrointestinal investigations and imaging were all normal apart from scintigraphy which confirmed delayed gastric emptying. The neurological symptoms disappeared after removal of an hemangioblastoma of the medullary cone. The persistent gastroparesis was treated by total gastrectomy with complete resolution of the patient's gastrointestinal symptoms.

  18. Comparison of effects of different weight loss education modes in postoperative patients with laparoscopic sleeve gas-trectomy%不同减肥教育方式对腹腔镜袖状胃切除减肥术后患者的影响

    Institute of Scientific and Technical Information of China (English)

    赵冬琴; 姜小良; 张华

    2016-01-01

    Objective To study the effect of individualized and collectivization weight loss education on postoperative body mass index(BMI),blood lipid and compliance behavior in the patients undergoing laparoscopic sleeve gastrectomy. Methods Fifty-four cases of laparoscopic sleeve gastrectomy for conducting weight loss in the First Affiliated Hospital of Chongqing Medical University from April 2013 to September 2015 were chosen and divided into the individualized education group (28 cases) and collectivization education group(26 cases) according to the operation order. BMI,blood lipid and compliance behavior before education and at 6 months after education were observed in the two groups and the causes were analyzed. Results BMI,waist circumference(WC) and blood lipid levels in the two groups were significantly lower than those before education,but the decrease of these 3 indexes in the individualize group were more significantly than that in the collectivization education group with statisti cal difference(P<0.05). In the aspect of compliance behavior,the compliance behavior effect after education in the two groups was better than that before education , but the compliance behavior after 6-month education in the individualized education group was superior to the collectivization education group,the difference was statistically significant(P<0.05). Conclusion Implementing the individualized education in the postoperative patients after laparoscopic sleeve gastrectomy can effectively control the body weight level and blood lipid level,increases the compliance behavior and has more superiority than the traditional collectivization education model.%目的:比较分析个体化与集体化减肥教育对行腹腔镜袖状胃切除术减肥患者术后体质量指数(BMI)、血脂及遵医行为的影响。方法选取2013年4月至2015年9月在重庆医科大学附属第一医院行腹腔镜袖状胃切除术减肥的患者54例。按手术先后次序,将其随

  19. Comparison of laparoscopy-assisted and open radical gastrectomy for advanced gastric cancer

    Science.gov (United States)

    Hao, Yingxue; Yu, Peiwu; Qian, Feng; Zhao, Yongliang; Shi, Yan; Tang, Bo; Zeng, Dongzhu; Zhang, Chao

    2016-01-01

    Abstract Laparoscopy-assisted gastrectomy (LAG) has gained international acceptance for the treatment of early gastric cancer (EGC). However, the use of laparoscopic surgery in the management of advanced gastric cancer (AGC) has not attained widespread acceptance. This retrospective large-scale patient study in a single center for minimally invasive surgery assessed the feasibility and safety of LAG for T2 and T3 stage AGC. A total of 628 patients underwent LAG and 579 patients underwent open gastrectomy (OG) from Jan 2004 to Dec 2011. All cases underwent radical lymph node (LN) dissection from D1 to D2+. This study compared short- and long-term results between the 2 groups after stratifying by pTNM stages, including the mean operation time, volume of blood loss, number of harvested LNs, average days of postoperative hospital stay, mean gastrointestinal function recovery time, intra- and post-operative complications, recurrence rate, recurrence site, and 5-year survival curve. Thirty-five patients (5.57%) converted to open procedures in the LAG group. There were no significant differences in retrieved LN number (30.4 ± 13.4 vs 28.1 ± 17.2, P = 0.43), proximal resection margin (PRM) (6.15 ± 1.63 vs 6.09 ± 1.91, P = 0.56), or distal resection margin (DRM) (5.46 ± 1.74 vs 5.40 ± 1.95, P = 0.57) between the LAG and OG groups, respectively. The mean volume of blood loss (154.5 ± 102.6 vs 311.2 ± 118.9 mL, P < 0.001), mean postoperative hospital stay (7.6 ± 2.5 vs 10.7 ± 3.6 days, P < 0.001), mean time for gastrointestinal function recovery (3.3 ± 1.4 vs 3.9 ± 1.5 days, P < 0.001), and postoperative complications rate (6.4% vs 10.5%, P = 0.01) were clearly lower in the LAG group compared to the OG group. However, the recurrence pattern and site were not different between the 2 groups, even they were stratified by the TNM stage. The 5-year overall survival (OS) rates were 85.38%, 79

  20. Effect of intensive vs conventional insulin therapy on perioperative nutritional substrates metabolism in patients undergoing gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Han-Cheng Liu; Yan-Bing Zhou; Dong Chen; Zhao-Jian Niu; Yang Yu

    2012-01-01

    AIM:To investigate the effect of intensive vs conventional insulin therapy on perioperative nutritional substrates metabolism in patients undergoing radical distal gastrectomy.METHODS:Within 24 h of intensive care unit management,patients with gastric cancer were enrolled after written informed consent and randomized to the intensive insulin therapy (IIT) group to keep glucose levels from 4.4 to 6.1 mmol/L or the conventional insulin therapy (CIT) group to keep levels less than 10 mmol/L.Resting energy expenditure (REE),respiratory quotient (RQ),resting energy expenditure per kilogram (REE/kg),and the lipid oxidation rate were monitored by the indirect calorimeter of calcium citrate malate nutrition metabolism investigation system.The changes in body composition were analyzed by multi-frequency bioimpedance analysis.Blood fasting glucose and insulin concentration were measured for assessment of Homeostasis model assessment of insulin resistance.RESULTS:Sixty patients were enrolled.Compared with preoperative baseline,postoperative REE increased by over 22.15% and 11.07%; REE/kg rose up to 27.22 ± 1.33 kcal/kg and 24.72 ± 1.43 kcal/kg; RQ decreased to 0.759 ± 0.034 and 0.791 ± 0.037; the lipid oxidation ratio was up to 78.25% ± 17.74% and 67.13% ± 12.76% supported by parenteral nutrition solutions from 37.56% ± 11.64% at the baseline; the level of Ln-HOMA-IR went up dramatically (P < 0.05,respectively) on postoperative days 1 and 3 in the IIT group.Meanwhile the concentration of total protein,albumin and triglyceride declined significantly on postoperative days 1 and 3 compared with pre-operative levels (P < 0.05,respectively).Compared with the CIT group,IIT reduced the REE/kg level (27.22 ± 1.33 kcal/kg vs 29.97 ± 1.47 kcal/kg,P =0.008; 24.72 ± 1.43 kcal/kg vs 25.66 ± 1.63 kcal/kg,P =0.013); and decreased the Ln-HOMA-IR score (P =0.019,0.028) on postoperative days 1 and 3; IIT decreased the level of CRP on postoperative days 1 and 3 (P

  1. Long-term clinical outcomes of laparoscopy-assisted distal gastrectomy versus open distal gastrectomy for early gastric cancer: A comprehensive systematic review and meta-analysis of randomized control trials.

    Science.gov (United States)

    Lu, Wei; Gao, Jian; Yang, Jingyun; Zhang, Yijian; Lv, Wenjie; Mu, Jiasheng; Dong, Ping; Liu, Yingbin

    2016-07-01

    The objective of this study was to compare long-term surgical outcomes and complications of laparoscopy-assisted distal gastrectomy (LADG) with open distal gastrectomy (ODG) for the treatment of early gastric cancer (EGC) based on a review of available randomized controlled trials (RCTs) evaluated using the Cochrane methodology.RCTs comparing LADG and ODG were identified by a systematic literature search in PubMed, Cochrane Library, MEDLINE, EMBASE, Scopus, and the China Knowledge Resource Integrated Database, for papers published from January 1, 2003 to July 30, 2015. Meta-analyses were performed to compare the long-term clinical outcomes.Our systematic literature search identified 8 eligible RCTs including 732 patients (374 LADGs and 358 ODGs), with low overall risk of bias. Long-term mortality and relapse rate were comparable for both techniques. The long-term complication rate was 8.47% in LADG groups and 13.62% in the ODG group, indicating that LADG was associated with lower risk for long-term complications (RR = 0.63; 95%CI = 0.39-1.00; P = 0.03).In the treatment of EGC, LADG lowered the rate of long- and short-term complications and promoted earlier recovery, with comparable oncological outcomes to ODG. PMID:27399073

  2. 腹腔镜肥胖外科临床应用指南(2008年版)

    Institute of Scientific and Technical Information of China (English)

    美国胃肠内镜外科医师学会; 沈莹莹

    2012-01-01

    [腹腔镜肥胖外科手术名词] 可调节胃束带术(adjustable gastric banding,AGB);胆胰转流术(biliopancreatic diversion,BPD);十二指肠转位术(duodenal switch,DS);Roux-en-Y胃旁路术(Roux-en-Y gastric bypass,RGB);腹腔镜袖状胃切除术(laparoscopic sleeve gastrectomy,LSG).

  3. Wear Resistance of Piston Sleeve Made of Layered Material Structure: MMC A356R, Anti-Abrasion Layer and FGM Interface

    Directory of Open Access Journals (Sweden)

    Hernik Szymon

    2016-09-01

    Full Text Available The aim of this paper is the numerical analysis of the one of main part of car engine – piston sleeve. The first example is for piston sleeve made of metal matrix composite (MMC A356R. The second improved material structure is layered. Both of them are comparison to the classical structure of piston sleeve made of Cr-Ni stainless steel. The layered material structure contains the anti-abrasion layer at the inner surface of piston sleeve, where the contact and friction is highest, FGM (functionally graded material interface and the layer of virgin material on the outer surface made of A356R. The complex thermo-elastic model with Archard's condition as a wear law is proposed. The piston sleeve is modelling as a thin walled cylindrical axisymmetric shell. The coupled between the formulation of thermo-elasticity of cylindrical axisymmetric shell and the Archard’s law with functionally changes of local hardness is proposed.

  4. The usefulness of levin tube inserted drip infusion spiral CT: comparison with conventional method in subtotal gastrectomy patients

    Energy Technology Data Exchange (ETDEWEB)

    Park, Young Jin; Kim, Young Hwan; Yoon, Jung Hee; Cha, Soon Joo; Kim, Jeong Sook [Sanggye Paik Hospital, Seoul (Korea, Republic of); Kim, Sung Rok; Hur, Gham; Rhim, Hyun Chul [Hanyang University Hospital, Seoul (Korea, Republic of)

    1998-04-01

    The purpose of this study is to access the usefulness of newly designed Levin tube inserted drip infusion spiral CT for the evaluation of remnant stomach and anastomosis site in patients who have undergone subtotal gastrectomy for stomach cancer. A new technique named Levin tube inserted drip infusion spiral CT was used to prospectively study 23 patients. A 16Fr Levin tube was inserted into the remnant stomach; 500 ml of tap water was drip infused just before CT scanning and an additional 500 ml of water was infused during IV contrast injection. Water was infused by gravity, using a water bottle suspended at a height of 90 cm (Group A). The 31 patients who underwent conventional spiral CT scanning immediately after the divided ingestion of 900 ml diluted gastrografin were selected as a control group (Group B). The anatomic delineation of the anastomosis site was graded by two radiologists as excellent (3), good(2), fair (1) or poor (0). To evaluate the degree of distension, the maximal diameters of remnant stomach and the anastomosis site, and the thickness of the stomach wall, were also measured. In patients who had undergone subtobal gastrectomy, Levin tube inserted drip infusion spiral CT showed excellent anatomic delineation of the site of anastomosis and remnant stomach. We found that because it increases the distension of remnant stomach and the anastomosis site, this technique is effective for the evaluation of postoperative stomach. (author). 10 refs., 2 tabs., 3 figs.

  5. Simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach

    Institute of Scientific and Technical Information of China (English)

    Qian-Lin Zhu; Feng Dong; Jun-Jun Ma; Ya-Ping Zong; Min-Hua Zheng; Bo Feng; Ai-Guo Lu; Min-Liang Wang; Jian-Wen Li; Wei-Guo Hu; Lu Zang; Zhi-Hai Mao

    2008-01-01

    Laparoscopic resection of rectal cancer or gastric cancer has been advocated for the benefits of a reduced morbidity,a shorter treatment time,and similar outcomes.However,simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach are rarely documented in literature.Endoscopic examination revealed a synchronous carcinoma of rectum and stomach in a 55-year-old male patient with rectal bleeding and epigastric discomfort.He underwent a simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy with regional lymph nodes dissected.The operation time was 270min and the estimated blood loss was 120mL.The patient required parenteral analgesia for less than 24h.Flatus was passed on postoperative day 3,and a solid diet was resumed on postoperative day 7.He was discharged on postoperative day 13.With the advances in laparoscopic technology and experience,simultaneous resection is an attractive alternative to a synchronous gastrointestinal cancer.

  6. Oncologic value of laparoscopy-assisted distal gastrectomy for advanced gastric cancer: A systematic review and meta-analysis

    Science.gov (United States)

    Aurello, Paolo; Sagnotta, Andrea; Terrenato, Irene; Berardi, Giammauro; Nigri, Giuseppe; D'Angelo, Francesco; Ramacciato, Giovanni

    2016-01-01

    BACKGROUND: The oncologic validity of laparoscopic-assisted distal gastrectomy (LADG) in the treatment of advanced gastric cancer (AGC) remains controversial. This study is a systematic review and meta-analysis of the available evidence. MATERIALS AND METHODS: A comprehensive search was performed between 2008 and 2014 to identify comparative studies evaluating morbidity/mortality, oncologic surgery-related outcomes, recurrence and survival rates. Data synthesis and statistical analysis were carried out using RevMan 5.2 software. RESULTS: Eight studies with a total of 1456 patients were included in this analysis. The complication rate was lower in LADG [odds ratio (OR) 0.59; 95% confidence interval (CI) = 0.42-0.83; P 0.05). CONCLUSION: The current study supports the view that LADG for AGC is a feasible, safe and effective procedure in selected patients. Adequate lymphadenectomy, resection margins, recurrence, cancer-related mortality and long-term outcomes appear equivalent to open distal gastrectomy (ODG). PMID:27279389

  7. Clinical experience of double sleeve lobectomy of the bronchus and the pulmonary artery in patients with central lung cancer

    Institute of Scientific and Technical Information of China (English)

    Yukang Kuang; Changying Guo; Laiduo Zeng; Dongsheng Wang; Binglin Yin; Jiufa Wu; Jian Huang; Zhisheng He; Jianfeng Zhu; Feng Jiang

    2013-01-01

    Objective: The aim of our study was to introduce the surgical method and evaluate the efficacy of double sleeve lobectomy of the bronchus and the pulmonary artery in treatment for the central lung cancer. Method: From March 1995 to October 2010, double sleeve lobectomy of the bronchus and the pulmonary artery was performed in 45 cases with central lung cancer that involved the bronchial opening of an upper lobe of the lungs or the main bronchus and pulmonary artery but didn't involve any lower lobes. Among them, left upper lobectomy was performed in 37 cases, right medium-upper lobectomy was performed in 6 cases and right upper lobectomy was performed in 2 cases. Results: Postoperative complications were found in 12 cases. Among them, 3 cases were arrhythmia, 1 case was acute heart failure, 6 cases were obstructive pneumonia and pulmonary atelectasis, 2 cases were bronchial anastomotic fistula. Two cases died of cerebral infarction and massive hemoptysis respectively. Thirty-one cases were squamous carcinoma, 7 cases were adenocarcinoma, 4 cases were small cell lung cancer, 1 case was adenosquamous carcinoma, 1 case was sarcomatoid carcinomas, 1 case was mucinous adenocarcinoma. Ten cases were T3N0M0, 11 cases were T3N1M0, 17 cases were T3N2M0, 2 cases were T4N1M0, 5 cases were T4N2M0. The 1-year, 3-year, 5-year survival rates were 84.4% (38/45), 51.7% (15/29), 53.8% (7/13) respectively. Conclusion: The double sleeve lobectomy of the bronchus and the pulmonary artery can maximumly reserve the normal lung tissues while removing tumors, and avoid pneumonectomy. The surgery was safe and effective, while it required a high technique.

  8. Perioperative analgesic requirements in severely obese adolescents and young adults undergoing laparoscopic versus robotic-assisted gastric sleeve resection

    Directory of Open Access Journals (Sweden)

    Anita Joselyn

    2015-01-01

    Full Text Available Purpose: One of the major advantages for patients undergoing minimally invasive surgery as compared to an open surgical procedure is the improved recovery profile and decreased opioid requirements in the perioperative period. There are no definitive studies comparing the analgesic requirements in patients undergoing two different types of minimally invasive procedure. This study retrospectively compares the perioperative analgesic requirements in severely obese adolescents and young adults undergoing laparoscopic versus robotic-assisted, laparoscopic gastric sleeve resection. Materials and Methods: With Institutional Review Board approval, the medication administration records of all severely obese patients who underwent gastric sleeve resection were retrospectively reviewed. Intra-operative analgesic and adjuvant medications administered, postoperative analgesic requirements, and visual analog pain scores were compared between those undergoing a laparoscopic procedure versus a robotic-assisted procedure. Results: This study cohort included a total of 28 patients who underwent gastric sleeve resection surgery with 14 patients in the laparoscopic group and 14 patients in the robotic-assisted group. Intra-operative adjuvant administration of both intravenous acetaminophen and ketorolac was similar in both groups. Patients in the robotic-assisted group required significantly less opioid during the intra-operative period as compared to patients in the laparoscopic group (0.15 ± 0.08 mg/kg vs. 0.19 ± 0.06 mg/kg morphine, P = 0.024. Cumulative opioid requirements for the first 72 postoperative h were similar in both the groups (0.64 ± 0.25 vs. 0.68 ± 0.27 mg/kg morphine, P = NS. No difference was noted in the postoperative pain scores. Conclusion: Although intraoperative opioid administration was lower in the robotic-assisted group, the postoperative opioid requirements, and the postoperative pain scores were similar in both groups.

  9. Diet after gastric banding

    Science.gov (United States)

    Gastric banding surgery - your diet; Obesity - diet after banding; Weight loss - diet after banding ... about any problems you are having with your diet, or about other issues related to your surgery ...

  10. Iliotibial band syndrome - aftercare

    Science.gov (United States)

    IT band syndrome - aftercare; Iliotibial band friction syndrome - aftercare ... If you have iliotibial band syndrome you may notice: Mild pain on the outside of your knee when you begin to exercise, which goes ...

  11. Development of sleeve type wired balance%套筒式张线天平的研制

    Institute of Scientific and Technical Information of China (English)

    张平; 赵长辉; 刘博宇

    2012-01-01

    According to the special requirements for aerodynamic loads tests of a civil aircraft model in wind tunnel, a wired balance of sleeve type is developed. This paper describes the encountered difficulties, the solution of key technology and the research results. The balance components are placed on the outer sleeve of 58mm in diameter, the diameter of inner rod is 44mm, and the outer sleeve and inner rod are joined together by welding around wedges. The components of normal force, pitching moment and rolling moment are pulled or pressed, the components deformation of side force and yaw moment are in 'S' types, and the component of axial force is deformed by bending. The supporting part on the components is pulled or pressed and has a good rigidity. By FEM, the strains of normal force and pitching moment are consistent with the calibration outputs. The test result shows that: the design of wired balance is reasonable, the system has a good rigidity composed of the outer sleeve and inner rod and wired support, and the measurement accuracy of each component of the balance is high.%根据民机张线测力试验的特殊要求,研制了一台套筒结构形式的张线天平.详细介绍了该天平在研制中遇到的难点、关键技术的解决措施以及研制的结果.天平元件布置在φ58mm的外套筒上,内杆直径为φ44mm,外套筒和内杆通过楔块焊接在一起.法向力、俯仰力矩和滚转力矩为拉压变形,横向力和偏航力矩为“S”形变形,轴向力为弯曲变形,元件支撑部分受拉压变形且刚度较强.通过对天平进行有限元分析,在法向力和俯仰力矩作用下,得出的应变结果与实际输出基本吻合.风洞试验结果表明:天平设计合理,天平外套筒、内杆及张线支撑系统刚度好,天平各分量测量精度高.

  12. The Influence of Splenectomy Performed Simultaneously with Gastrectomy on Postoperative Complications in Patients with Gastric Cancer Undergoing Surgery with the Intention to Treat

    Directory of Open Access Journals (Sweden)

    Głuszek Stanisław

    2014-07-01

    Full Text Available Despite the growing understanding of the pathophysiological processes in the perioperative period and significant advancements in surgical techniques, operative treatment for gastric cancer remains a challenge for surgeons, especially because the primary procedure of total or nearly total gastrectomy must at times be extended by the resection of other organs.

  13. Effects of Prolonged Empirical Antibiotic Administration on Post-Surgical Intestinal Bacterial Flora of Local Dogs Undergoing Non-Laparoscopic Gastrectomy

    Directory of Open Access Journals (Sweden)

    J.F. Akinrinmade

    2015-07-01

    Full Text Available Prolonged post-surgical antibiotic administration may be of less advantage in prevention of post-surgical infections. This study therefore, aimed at investigating the prolonged effect of empiric administration of three most-prescribed antibiotics (amoxicillin, cefotaxime and oxytetracycline by veterinary practices in Southwest Nigeria on intestinal bacterial population of dogs undergoing partial, non-laparoscopic gastrectomy. Using conventional quantitative and qualitative microbial culture procedures, the total bacterial populations were mostly too numerous to count (TNTC before gastrectomy but log103-105 cfu/mL after, while control were log 105-107 cfu/mL after gastrectomy. On general-purpose, special, differential and selective culture media, total bacterial counts with increasing post-operative days were- amoxicillin (11 mg/kg day 4: log 105-10-9/TNTC cfu/mL vs. day 8: log 103-105 cfu/mL; cefotaxime (25 mg/kg day 4: log 103-108/TNTC/cfu/mL vs. day 8: log 102-105 cfu/mL; oxytetracycline (10 mg/kg day 4: log 104-109 TNTC cfu/mL vs. day 8: log 102-106 cfu/mL. Total bacterial counts of control animals were- day 4: log 105-108/TNTC cfu/mL vs. day 8: log 105-109. Total qualitative populations of predominant, easily-recoverable aerobic and anaerobic rectal canine bacteria, Bacillus, Citrobacter aerogenes, Clostridium, E. coli, Klebsiella, Enterobacter, Proteus, Pseudomonas, Salmonella, Shigella, Streptococcus, Staphylococcus and lactobacilli were significantly less after gastrectomy but reductions in post-operative bacterial populations were mostly more pronounced among the anaerobes (lactobacilli and Clostridium perfringens. No post-operative infection was recorded among all the experimental animals, including the control animals. In conclusion, this study confirmed significant reduction effect of prolonged empiric antibiotic administration on rectal (intestinal bacterial populations of experimental local dogs that had partial, non

  14. Finite element calculation and direct x-ray diffraction measurement of residual stresses induced by an hydraulic expansion in steam generator tubes during the sleeving process

    International Nuclear Information System (INIS)

    When installing an internal sleeve to repair a steam generator tube, it is usual to expand the sleeve locally by means of an internal pressure, in order to put it into contact with the tube before welding. This process induces residual stresses in the parent tube, near the end of the contact zone, even if the residual bulging is very small. This study is aimed at assessing the residual stresses as a function of that bulging and of the respective mechanical properties of the materials. An analytical approach based on finite element calculations and an experimental one by x-ray diffraction have been used to evaluate the residual stresses

  15. Using a guide template with a handpiece sleeve to locate the abutment screw position of a cement-retained implant restoration.

    Science.gov (United States)

    Kang, Hye-Won; Lee, Du-Hyeong

    2015-09-01

    The existing techniques for drilling a screw access hole in cement-retained restorations are limited by inaccurate drill guidance and ineffective cooling of the drilling area. An approach for fabricating a guide template to provide screw retrievability using computer-aided design and computer-aided manufacturing (CAD/CAM) is described. A handpiece sleeve was made by 3-dimensional printing and incorporating it into a vacuum-formed template. The handpiece sleeve not only guides the head of the handpiece accurately but also enables the cooling water to reach the area of drilling directly. PMID:26013071

  16. Gastric wall thickening on spiral CT after subtotal gastrectomy for gastric cancer: comparision between recurrent caner and benign thickening

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chang Sook; Choi, Jong Cheol; Yoon, Sung Kuk; Kim, Jae Ik; Oh, Jong Young; Kang, Myung Jin; Lee, Ki Nam; Nam, Kyuung Jin [Donga Univ. College of Medicine, Pusan (Korea, Republic of)

    2000-12-01

    To determine the features revealed by two-phase spiral CT scanning useful for differential diagnosis between recurrent cancer and benign wall thickening in patients who have undergone subtotal gastrectomy for stomach cancer. We retrospectively reviewed 25 cases in which wall thickening of more than 1cm in the remnant stomach after subtotal gastrectomy was revealed by two-phase spiral CT scanning. All cases were confirmed: 11 were recurrent cancer, and in 14, benign wall thickening was demonstrated. We analyzed the CT findings including maximal thickness of the gastric wall, patterns of wall thickening, degree of contrast enhancement seen during the arterial and portal phases, and the presence of perigastric strands. Maximal wall thickness was classified as either more or less than 15mm, and as either focal or diffuse. We also determined whether lymphadenopathy was present. Mean maximal gastric wall thickness was 18.4mm in the recurrent cancer group ({sup g}roup A{sup )} and 12.6mm in the benign group ({sup g}roup B{sup )}. The gastric wall was thicker than 15mm in 10 of 11 group A cases and in 3 of 14 in group B; wall thickening was focal (n=3) or diffuse (n=8) in group A, and focal (n=13) or diffuse (n=1) in group B, while the enhancement patterns seen during the arterial and portal phase, respectively, were high/high (n=8), low/high (n=1) and low/low (n=2) in group A, and low/low (n=7), low/high (n=4), high/low (n=1) and high/high (n=2) in group B. Perigastric strands were observed in nine cases in group A, but in none in group B, while lymphadenopathy was combined with wall thickening in seven group A cases but in none of those in group B. In patients who have undergone subtotal gastrectomy for gastric cancer, two-phase spiral CT findings including maximal thickness of the gastric wall, patterns of wall thickening, degree of contrast enhancement seen during the arterial and portal phase, the presence of perigastric strands, and lymphadenopathy are useful for

  17. Effects of glutamine-containing total parenteral nutrition on phagocytic activity and anabolic hormone response in rats undergoing gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Chen-Hsien Lee; Wan-Chun Chiu; Soul-Chin Chen; Chih-Hsiung Wu; Sung-Ling Yeh

    2005-01-01

    AIM: To investigate the effect of glutamine (Gln)-containing parenteral nutrition on phagocytic activity and to elucidate the possible roles of Gin in the secretion of anabolic hormones and nitrogen balance in rats undergoing a gastrectomy.METHODS: Rats with an internal jugular catheter were divided into 2 experimental groups and received total parenteral nutrition (TPN). The TPN solutions were isonitrogenous and identical in nutrient compositions except for differences in amino acid content. One group received conventional TPN (control), and in the other group, 25%of the total amino acid nitrogen was replaced with Gln.After receiving TPN for 3 d, one-third of the rats in each experimental group were sacrificed as the baseline group.The remaining rats underwent a partial gastrectomy and were killed 1 and 3 d, respectively, after surgery. Plasma,peritoneal lavage fluid (PLF), and urine samples were collected for further analysis.RESULTS: The Gin group had fewer nitrogen losses 1 and 2 d after surgery (d1, 16.6±242.5 vs -233.4±205.9 mg/d,d2, 31.8±238.8 vs-253.4±184.6 mg/d, P<0.05). There were no differences in plasma growth hormone (GH) and insulin-like growth factor-1 levels between the 2 groups before or after surgery. The phagocytic activity of peritoneal macrophages was higher in the Gin group than in the control group 1 d after surgery (4 1185±931 vs 323±201,P<0.05). There were no differences in the phagocytic activities of blood polymorphonuclear neutrophils between the 2 groups at the baseline or on the postoperative days.No significant differences in interleukin-1β or interleukin-6concentrations in PLF were observed between the 2 groups.However, tumor necrosis factor-α level in PLF was significantly lower in the Gin group than in the control group on postoperative d 3.CONCLUSION: TPN supplemented with Gin can improve the nitrogen balance, and enhance macrophage phagocytic activity at the site of injury. However, Gin supplementation has no effect

  18. Carbon dioxide pneumothorax occurring during laparoscopy-assisted gastrectomy due to a congenital diaphragmatic defect: a case report.

    Science.gov (United States)

    Park, Hye-Jin; Kim, Duk-Kyung; Yang, Mi-Kyung; Seo, Jeong-Eun; Kwon, Ji-Hye

    2016-02-01

    During laparoscopic surgery, carbon dioxide (CO2) pneumothorax can develop due to a congenital defect in the diaphragm. We present a case of a spontaneous massive left-sided pneumothorax that occurred during laparoscopy-assisted gastrectomy, because of an escape of intraperitoneal CO2 gas, under pressure, into the pleural cavity through a congenital defect in the esophageal hiatus of the left diaphragm. This was confirmed on intraoperative chest radiography and laparoscopic inspection. This CO2 pneumothorax caused tolerable hemodynamic and respiratory consequences, and was rapidly reversible after release of the pneumoperitoneum. Thus, a conservative approach was adopted, and the remainder of the surgery was completed, laparoscopically. Due to the high solubility of CO2 gas and the extra-pulmonary mechanism, CO2 pneumothorax with otherwise hemodynamically stable conditions can be managed by conservative modalities, avoiding unnecessary chest tube insertion or conversion to an open procedure. PMID:26885310

  19. Treatment of gastric remnant cancer post distal gastrectomy by endoscopic submucosal dissection using an insulation-tipped diathermic knife

    Institute of Scientific and Technical Information of China (English)

    Shoji Hirasaki; Hiromitsu Kanzaki; Minoru Matsubara; Kohei Fujita; Shuji Matsumura; Seiyuu Suzuki

    2008-01-01

    AIM: To evaluate the effectiveness of endoscopic submucosal dissection using an insulation-Upped diathermic knife (IT-ESD) for the treatment of patients with gastric remnant cancer.METHODS: Thirty-two patients with early gastric cancer in the remnant stomach, who underwent distal gastrectomy due to gastric carcinoma, were treated with endoscopic mucosal resection (EMR) or ESD at Sumitomo Besshi Hospital and Shikoku Cancer Center in the 10-year period from January 1998 to December 2007, including 17 patients treated with IT-ESD.Retrospectively, patient backgrounds, the one-piece resection rate, complete resection (CR) rate, operation time, bleeding rate, and perforation rate were compared between patients treated with conventional EMR and those treated with IT-ESD.RESULTS- The CR rate (40% in the EMR group ys 82% in the IT-ESD group) was significantly higher in the IT-ESD group than in the EMR group; however,the operation time was significantly longer for the ITESD group (57.6±31.9 min vs 21.1±12.2 min).No significant differences were found in the rate of underlying cardiopulmonary disease (IT-ESD group, 12% ys EMR group, 13%), one-piece resection rate (100% vs 73%), bleeding rate (18% vs 6.7%), and perforation rate (0% vs 0%) between the two groups.CONCLUSION: IT-ESD appears to be an effective treatment for gastric remnant cancer post distal gastrectomy because of its high CR rate.It is useful for histological confirmation of successful treatment.The long-term outcome needs to be evaluated in the future.

  20. The GYMSSA trial: a prospective randomized trial comparing gastrectomy, metastasectomy plus systemic therapy versus systemic therapy alone

    Directory of Open Access Journals (Sweden)

    Berger Ann

    2009-12-01

    Full Text Available Abstract Background The standard of care for metastatic gastric cancer (MGC is systemic chemotherapy which leads to a median survival of 6-15 months. Survival beyond 3 years is rare. For selected groups of patients with limited MGC, retrospective studies have shown improved overall survival following gastrectomy and metastasectomies including peritoneal stripping with continuous hyperthermic peritoneal perfusion (CHPP, liver resection, and pulmonary resection. Median survival after liver resection for MGC is up to 34 months, with a five year survival rate of 24.5%. Similarly, reported median survival after pulmonary resection of MGC is 21 months with long term survival of greater than 5 years a possibility. Several case reports and small studies have documented evidence of long-term survival in select individuals who undergo CHPP for MGC. Design The GYMSSA trial is a prospective randomized trial for patients with MGC. It is designed to compare two therapeutic approaches: gastrectomy with metastasectomy plus systemic chemotherapy (GYMS versus systemic chemotherapy alone (SA. Systemic therapy will be composed of the FOLFOXIRI regimen. The aim of the study is to evaluate overall survival and potential selection criteria to determine those patients who may benefit from surgery plus systemic therapy. The study will be conducted by the Surgery Branch at the National Cancer Institute (NCI, National Institutes of Health (NIH in Bethesda, Maryland. Surgeries and followup will be done at the NCI, and chemotherapy will be given by either the local oncologist or the medical oncology branch at NCI. Trial Registration ClinicalTrials.gov ID. NCT00941655

  1. Dietary 2-oxoglutarate mitigates gastrectomy-evoked structural changes in cartilage of female rats.

    Science.gov (United States)

    Dobrowolski, Piotr; Tomaszewska, Ewa; Kurlak, Paulina; Pierzynowski, Stefan G

    2016-01-01

    Gastrectomy (Gx) leads to osteopenia/osteoporosis in humans and animals. However, little is known about the influence of Gx on the cartilage in this regard. Recent studies have demonstrated a protective effect of 2-oxoglutaric acid (2-Ox) on bone and cartilage. Hence, the purpose of this study was to investigate whether 2-Ox can mitigate eventual Gx-induced cartilage impairment. Twenty female Sprague-Dawley rats were subjected to Gx and randomly divided into two groups: Gx + 2-Ox and Gx. Another 20 rats were sham-operated (ShO) and randomly divided into two groups: ShO + 2-Ox and ShO. The daily dose of 2-Ox administered to the rats in the drinking water was 0.43 g per 100 g rat. After eight weeks, rats were euthanized and femora and tibiae were collected. Histology and histomorphometry analyses of the articular cartilage and the growth plate were done. Gx resulted in a 32% (±44.5 femur, ±35.8 tibia) decrease in overall thickness of articular cartilage in both bones (femur: ShO 279.1 ± 48.5 vs. Gx 190.2 ± 38.4 µm, tibia: ShO 222.9 ± 50.3 µm vs. Gx 151.3 ± 52.6 µm) (in some zones up to 58 ± 28.0%), and in the growth plate up to 20% (±22.4) (femur: ShO 243.0 ± 34.0 vs. Gx 207.0 ± 33.7 µm, tibia: ShO 220.0 ± 24.6 µm vs. Gx 171.1 ± 16.1 µm). Gx altered the spatial distribution of thick and thin collagen fibers, and chondrocyte shape and size. 2-Ox administration prevented the reduction in both cartilages thickness (Gx + 2-Ox: articular cartilage 265.2 ± 53.8 µm, 235.6 ± 42.7 µm, growth plate 236.7 ± 39.2 µm, 191.3 ± 16.5 µm in femur and tibia, respectively), and abolished the spatial changes in collagen distribution and structure induced by Gx. Gx affects cartilage structure and thickness, however, 2-Ox administration mitigates these effects and showed protective and stimulatory properties. Our observations suggest that dietary 2-Ox can be used to offset

  2. Band structure of semiconductors

    CERN Document Server

    Tsidilkovski, I M

    2013-01-01

    Band Structure of Semiconductors provides a review of the theoretical and experimental methods of investigating band structure and an analysis of the results of the developments in this field. The book presents the problems, methods, and applications in the study of band structure. Topics on the computational methods of band structure; band structures of important semiconducting materials; behavior of an electron in a perturbed periodic field; effective masses and g-factors for the most commonly encountered band structures; and the treatment of cyclotron resonance, Shubnikov-de Haas oscillatio

  3. 铝硅合金套筒裂纹修复%Repairing of Aluminum-silicon Alloy Sleeve Crack

    Institute of Scientific and Technical Information of China (English)

    柯娜; 邵洪波

    2013-01-01

    This article summarizes the experience and technical measures of aluminum-silicon alloy sleeve crack repairing. The successful repairing is ensured by measures of defect location, segmented elimination, preheating, improving the stress condition of the repairing welding line and segmented welding.%本文总结介绍了铝硅合金套筒裂纹返修的经验和技术措施。主要叙述了从缺陷的定位、分段清除、预热、改善返修焊缝处的受力状态、分段焊接等措施,保证返修的成功率。

  4. Band parameters of phosphorene

    DEFF Research Database (Denmark)

    Lew Yan Voon, L. C.; Wang, J.; Zhang, Y.;

    2015-01-01

    Phosphorene is a two-dimensional nanomaterial with a direct band-gap at the Brillouin zone center. In this paper, we present a recently derived effective-mass theory of the band structure in the presence of strain and electric field, based upon group theory. Band parameters for this theory are co...

  5. Flat Band Quastiperiodic Lattices

    Science.gov (United States)

    Bodyfelt, Joshua; Flach, Sergej; Danieli, Carlo

    2014-03-01

    Translationally invariant lattices with flat bands (FB) in their band structure possess irreducible compact localized flat band states, which can be understood through local rotation to a Fano structure. We present extension of these quasi-1D FB structures under incommensurate lattices, reporting on the FB effects to the Metal-Insulator Transition.

  6. [Esophagojejunal anastomoses with the EEA stapler after total gastrectomy. Technic and immediate results apropos of a recent series of 32 cases].

    Science.gov (United States)

    Le Treut, Y P; Delpero, J R; Sabiani, P; Berthet, B; Bozon-Verduraz, E; Pol, B; Bricot, R

    1987-12-01

    32 consecutive total gastrectomies for cancer (20 extended total gastrectomies) were carried out through an abdominal approach. Reconstruction using a Rouxen-Y loop (28 cases) or an interposed jejunal loop (four cases) was done with an EEA stapled oesophago jejunostomy: 25 end to side and 5 end to end anastomosis were performed and two technical failures led to complete manual anastomosis. All patients have had post-operative X-ray examination: there was no anastomotic leakage in this series, even in the 3 patients (10%) who have died during the post-operative course. A critical study of this series and eight others one from elsewhere is presented: it is concluded that the stapling device allows an easier and safer oesophagojejunostomy than manual procedure, when great care is taken of technical details. PMID:3436987

  7. Effect of ivaradine on hyperpolarization activated cation current in canine pulmonary vein sleeve cardiomyocytes with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    Yang Li; Yan Huang; Zongbin Li; Hao Wang; Jianguo Song; Yuqi Liu; Lei Gao; Shiwen Wang

    2008-01-01

    Objective To study the effect of ivabradine on hyperpolarization activated cation current in canine pulmonary vein(PY) sleeve cardiomyocytes with atrial fibrillation.Methods Dissociation of PVs yielded single cardiomyocytes from a Landengorff column without or with pacemaker activity from long-term rapidly atrial pacing (RAP) canines.If current was measured with the whole-cell patch-clamp technique.Results Compared with the control group,the rapidly atrial pacing canine PV cardiomyocytes had spontaneous diastolic depolarization and had larger If densities.Ivabradine (Iva,1 μM),a selective inhibitor of the If current,markedly reduced If currents in the RAP from -2.66±0.4 pA/pF to -1.58±0.1 pA/pF at the test potential of-120 mV (P<0.01,n=12).Inhibition effect of Iva of If current showed concentration-dependent range from 0.1 to 10.0μM,with IC50 of 2.2 μ M ( 1.8-2.9 μM,95% CL).Furthermore,V1/ of steady-state activated curve was shifted from -84.3±4.9 mV to -106.9±3.4 mV and k value of steady-state activated curve was changed from 12.1+2.6 mV to 9.9±3.4 mV by the application of.1.0 μM Iva ( P<0.01,n=12).Conclusions Our study revealed that Ivarbadine may significantly decrease If of rapidly atrial pacing pulmonary vein sleeve ceUs with atrial fibdllation.(J Geriatr Cardiol 2008;5:39-42)

  8. Kinesiology Tape or Compression Sleeve Applied to the Thigh Does Not Improve Balance or Muscle Activation Before or Following Fatigue.

    Science.gov (United States)

    Cavanaugh, M Tyler; Quigley, Patrick J; Hodgson, Daniel D; Reid, Jonathan C; Behm, David G

    2016-07-01

    Cavanaugh, MT, Quigley, PJ, Hodgson, DD, Reid, JC, and Behm, DG. Kinesiology tape or compression sleeve applied to the thigh does not improve balance or muscle activation before or following fatigue. J Strength Cond Res 30(7): 1992-2000, 2016-Compression sleeves (CS) and kinesiology tape (KT) are purported to enhance proprioception, however, there is substantial conflict in the literature. Because the beneficial effects of CS and KT are more evident in the literature with recovery, the objective of this study was to examine the effects of CS and KT on balance under acute nonfatigued and postfatigued conditions. Using a within-subject, repeated-measures design, 12 university participants (5 females and 7 males) performed in a random order CS, KT, and Control conditions. Two trials of each test were conducted before the application of CS or KT (pretest 1), immediately after the application (pretest 2), with posttests at 1 and 10 minutes after 4 sets of unilateral Bulgarian squats to failure (1 minute rest between sets). Tests included a Y balance test (measures: distance reached by nondominant foot in anterior, posterior lateral, and posterior medial directions) and drop jump landing balance test from a 50-cm platform (measures: ground reaction force, electromyography, and center of pressure). The fatigue protocol induced 25.3% decrease in unilateral squat repetitions from set 1 to set 4. There were no significant condition main effects or interactions for any balance measure or EMG before or after fatigue. In conclusion, independent of fatigue, there was no significant effect of CS or KT on balance outcomes immediately and up to 10 minutes following the fatiguing intervention. Thus, nonfatigued or muscles weakened by fatigue did not benefit from CS and KT application. PMID:26705066

  9. Negative Effects of Total Gastrectomy on Bone Tissue Metabolism and Volumetric Bone Mineral Density (vBMD) of Lumbar Spine in 1-Year Study in Men.

    Science.gov (United States)

    Krupski, Witold; Tatara, Marcin R; Bury, Pawel; Szabelska, Anna; Charuta, Anna; Maciejewski, Ryszard; Wallner, Grzegorz; Dabrowski, Andrzej

    2016-02-01

    Gastrectomy induces severe osteoporosis in humans but its quantitative scale within trabecular and cortical compartments was not estimated. The aim of the study was to determine changes of volumetric bone mineral density (vBMD) in lumbar vertebrae (L1-L4) and biochemical bone metabolism markers in serum of patients 1 year after total gastrectomy. The control group consisted of patients (N = 8) subjected to abdominal surgery due to cardiospasmus. Total gastrectomy was performed in the experimental group (N = 6). Volumetric bone mineral density of trabecular and cortical bone of lumbar spine was measured before (baseline) and 1 year after the gastric surgery using the quantitative computed tomography method. Serum concentrations of insulin, insulin-like growth factor-1, tyroxine, interleukin-6, C-terminal telopeptides of type II collagen and bone formation, and resorption markers were determined at baseline and 1 year later, using ELISA, EIA, and IEMA methods. Total gastrectomy induced significant decrease of vBMD values, up to 16.8% and 10.0%, within the trabecular and cortical bone compartments of lumbar spine (P < 0.05). These negative changes of vBMD were associated with significantly increased serum concentration of bone resorption markers such as deoxypyridinoline, pyridinoline, and C-terminal telopeptides of type I collagen, by 13.5%, 32.2%, and 121.5%, respectively (P < 0.05). Neither vBMD nor biochemical bone turnover markers and hormone concentrations were influenced in the control patients. Dramatic bone loss during the first year in gastrectomized patients has proven dynamic osteoporosis progress indicating an importance of treatment interventions in these patients with emphasis on inhibition of intensive bone resorption processes. PMID:26886633

  10. The Effect of Thermal Double Distilled Water on Gastric Cancer Cell Line and Its Effect in Peritoneal Lavage During Radical Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    CHENJunqing; XUHuimian; 等

    2002-01-01

    Objective:To evaluate the effect andindications of radical gastrectomy combined with peritoneal lavage with thermal double distilled water(DDW)or DDW plus chlorthexidine acetate.Methods:On the bases of the study on the killing effect of 43℃ DDW on human gastric cancer cell line MGC-803 and its inhibiting effect on ascitic tumor of SY86B morse,500 cases of gastric cancer who underwent radical gastectomy from January 1986 to December 1995 were divided into three groups:group A(n=198) subject to radical gastrectomy and peritoneal lavage for 10min with 4000ml DDW at 43℃ ;group B(n=89)subject to radical gastrectomy and peritoneal lavage for 4min with 4000ml DDW plus 0.6g chlorthexidine acetate,and grup C(n=213) subject to radical gastrectomy and peritoneal lavage for 4 min with 4000ml normal saline at room temperature as control.Results Human gastric cancer cells MGC-803 could be completely killed by treatment of either 43℃ DDW for 10min or DDW plus 0.015ml/L chlorhexidine acetate for 4 min.Clinical trials proved group A and group B(called lavage group as a whole)had almost the same curative effects.The 1-year survival rate and 3-year survival rate were similar in different stages among the groups.The 5-year survival rate was 63.8% in the lavage group and 51.2% in the control group respectively.Most of the cases with good effect were at the mid-stage (Ⅱand Ⅲ stage).Conclusion Radical gastrectom combined with peritoneal peritoneal lavage before closing the abdomen has satisfying effect on patients with gastric cancer at stage Ⅱ and stage ⅢA.

  11. A comparative study of clinical effect on the Da Vinci surgical robot-assisted and laparoscopic-assisted distal subtotal gastrectomy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Objective:To evaluate the feasibility, safety and the clinical outcomes of the robotic distal gastrectomy for gastric cancer.Methods: We retrospectively analyzed the clinical and follow-up data of 113 cases underwent robotic distal gastrectomy from March 2010 to July 2013.Results:Compared with laparoscopic group, the robotic group had less intraoperative blood loss, more lymph nodes dissection (P<0.05). hTere was no signiifcant difference in the incidence of postoperative complications and neutrophil-lymphocyte ratio between the two groups. hTe follow-up data showed that the 1-, 2- and 3-year survival rates were 91.7%, 77.4% and 72.9% in robotic group while they were 91.2%, 76.2% and 70.4% in laparoscopic group ,and the difference was not significant. Conclusion:Robotic distal gastrectomy for gastric cancer is safe and effective, and it has less harm to the patients, with less intraoperative blood loss, more lymph nodes dissection and quicker postoperative recover than laparoscopic surgery, so it is worthy of popularization and application.

  12. Band Interaction between Chiral Doublet Bands

    Institute of Scientific and Technical Information of China (English)

    QI Bin; ZHANG Shuang-Quan; WANG Shou-Yu; MENG Jie

    2010-01-01

    @@ Band interaction between the chiral doublet bands based on πh11/2(×) vh-111/2 configuration is investigated in the particle rotor model with different triaxial deformation γ. The variation of chiral partner states with γvalues is understood qualitatively based on the basic picture of two interaction levels, which is confirmed further by the calculated overlap integral of wave functions at different γ values. It is found that the interaction strengths ofchiral partner states are obvionsly different for odd spins and even ones.

  13. Short-term effects of supplementary feeding with enteral nutrition via jejunostomy catheter on post-gastrectomy gastric cancer patients

    Institute of Scientific and Technical Information of China (English)

    WU Quan; YU Jian-chun; KANG Wei-ming; MA Zhi-qiang

    2011-01-01

    Background Most gastric cancer patients who undergo gastrectomy develop malnutrition.It is,therefore,crucial to establish an effective means to provide nutrition for these patients.To perform home enteral nutrition (EN) to ensure adequate nutritional intake in gastric cancer patients,we placed a jejunostomy catheter during gastric surgery.Most patients showed improved nutritional status.Methods Twenty-nine inpatients at our hospital underwent radical gastrectomy and jejunostomy from December 2002 to December 2007 and were designated as the jejunostomy group,and 32 matched patients without a jejunostomy tube were designated as the tube-free group.The jejunostomy group was treated with EN from 72 hours to 3 months postoperatively.The tube-free group did not receive EN.Data including preoperative and postoperative body weight,body mass index (BMI),nutrition risk screening (NRS) score,Karnofsky performance score (KPS),and laboratory biochemical indicators were documented respectively and compared.Results Compared with preoperative week 1,both groups showed decreased body weight and BMI at 3 months postoperatively.The weight loss in the jejunostomy group ((7.1±3.3) kg) was significantly less than that in the tube-free group ((9.9±3.1) kg).Similarly,BMI decreased by (2.4+1.0) kg/m2 in the jejunostomy group,which was significantly less than in the tube-free group ((3.2±0.9) kg/m2).The number of patients with postoperative NRS ≥3 was decreased in the jejunostomy group,but was increased in the tube-free group,and this difference was significant.There were no significant differences between the two groups in total lymphocyte count,hemoglobin,albumin and prealbumin,and adverse drug effects.Conclusions Short-term (3 months) EN supplementation via jejunostomy tube can reduce the risk of malnutrition and weight loss,and improve tolerance of chemotherapy.Tube feeding is reliable for achieving these goals because it is not important whether or not the patients have appetites.

  14. One-man band

    OpenAIRE

    Stillman, R.

    2013-01-01

    This website presents practice-based research related to solo simultaneous instrumental performance ('one-man band'). The site was conceived as a creative and widely accessible platform for music and ideas resulting from one-man band activates carried out between 2008 and 2013. Central to this project is an interest in how one-man band technique informs compositional process, including studio production. Through presentation and analysis of the author’s own creative practice, the site exp...

  15. On construction technique for straight screw thread sleeve connection%直螺纹套筒连接施工技术

    Institute of Scientific and Technical Information of China (English)

    王兆莉

    2012-01-01

    Combining the engineering examples, the paper briefly introduces the key technical points in the straight screw thread sleeve connection, including the splice processing, the reinforced steel connection, and so on, and points out the features for the reinforced steel straight screw thread sleeve connection, such as the convenient construction, reliable connection quality, no open fire and pollution, so it has extensive application perspective.%结合工程实例,简要介绍了直螺纹套筒连接中丝头加工、钢筋连接等关键技术要点,并指出钢筋直螺纹套筒连接技术具有施工方便、连接质量可靠、无明火、无污染等特点,有广泛的应用前景。

  16. 巧用钢筋直螺纹套筒连接技术%Using Rebar Straight Thread Sleeve Connecting Technology

    Institute of Scientific and Technical Information of China (English)

    曾良雄; 王艺颖

    2012-01-01

    The paper used Rebar Straight Thread Sleeve Connecting Technology promoted by the Ministry of Construction and the steel scrap in site to process a set group of sleeves to be embed in the concrete wall and change the connections from of ladder and concrete wall from welding to bolt, which improved the speed of construction and ensured the construction quality and safety.%采用建设部推广的钢筋直螺纹套筒连接技术,利用工地的钢筋废料,加工成为一组组套筒,预埋于混凝土筒壁中,将爬梯与混凝土筒壁的惯用连接方式由焊接改为螺栓连接,提高了施工速度,保证了施工质量和人员安全.

  17. Synthesis and electrochemical performances of ZnO/MnO2 sea urchin-like sleeve array as anode materials for lithium-ion batteries

    International Nuclear Information System (INIS)

    MnO2 is electrodeposited onto ZnO nanorod array grown on Ni foil, forming a binder-free ZnO/MnO2 composited electrode. XRD, EDS, SEM and TEM are used to analyze the phase and microstructure of this composite. Burr-like MnO2 nanoflakes grows on ZnO nanorod array, the top of the composite is hollow and at the bottom exists ZnO large block core as an internal support, forming ZnO/MnO2 sea urchin-like sleeve array. As anode material for lithium ion batteries, ZnO/MnO2 sleeve array exhibits higher discharge capacity and coulombic efficiency, better rate performance and cycling stability than single ZnO nanorod array or directly electrodepsited MnO2, and the composite effect is very remarkable. After 100 cycles, the discharge capacity of ZnO/MnO2 still reaches 1259 mA h g−1, and coulombic efficiency surpasses 98%, higher than those of ZnO nanorod array (111 mA h g−1) and directly electrodeposited MnO2 (507 mA h g−1). The improvement of the electrochemical performances is due to the unique sea urchin-like sleeve array architecture. MnO2 burr tube shell structure leads to high electrochemical activity while the internal ZnO core support ensures good structure stability. The gradually opening of sea urchin-like sleeve during the cycling further enhances the electrochemical activity of MnO2, stabilizing and increasing electrochemical performances of the ZnO/MnO2 composite

  18. 电切法袖套式包皮环切术200例临床分析%Electric cutting sleeve circumcision : clinical analysis of 200 cases

    Institute of Scientific and Technical Information of China (English)

    邹义华; 陈晓峰; 陈善群

    2012-01-01

    Objective:To evaluate the safety and effect of electric cutting sleeve circumcision for treatment of patients with redundant prepuce and phimosis. Method: Using electric cutting sleeve circumcision in 200 cases, the curative effect, complications and their prevention measures were analyzed. Result:The 200 cases of electric cutting sleeve circumcision show little bleeding, neat cutting, slight postoperative wound edema, little scar and satisfactory appearance of penis. Conclusion: With more satisfactory curative effect and fewer complications, Electric sleeve circumcision for treatment of patients with redundant prepuce and phimosis is worthy of clinical application.%目的:探讨电切法袖套式包皮环切术治疗包皮过长与包茎患者的安全性与疗效.方法:采用电切法袖套式包皮环切术治疗包皮过长与包茎患者200例,分析手术效果、并发症及其预防措施.结果:200例电切法袖套式包皮环切术出血少、切缘整齐,术后包皮水肿轻微,切口均一期愈合,癜痕少,阴茎外观满意.结论:电切法袖套式包皮环切术治疗包皮过长与包茎患者效果满意,并发症少,值得临床推广.

  19. Is gastrectomy-induced high turnover of bone with hyperosteoidosis and increase of mineralization a typical osteomalacia?

    Directory of Open Access Journals (Sweden)

    Takashi Ueyama

    Full Text Available Gastrectomy (GX is thought to result in osteomalacia due to deficiencies in Vitamin D and Ca. Using a GX rat model, we showed that GX induced high turnover of bone with hyperosteoidosis, prominent increase of mineralization and increased mRNA expression of both osteoclast-derived tartrate-resistant acid phosphatase 5b and osteocalcin. The increased 1, 25(OH2D3 level and unchanged PTH and calcitonin levels suggested that conventional bone and Ca metabolic pathways were not involved or changed in compensation. Thus, GX-induced bone pathology was different from a typical osteomalacia. Gene expression profiles through microarray analysis and data mining using Ingenuity Pathway Analysis indicated that 612 genes were up-regulated and 1,097 genes were down-regulated in the GX bone. These genes were related functionally to connective tissue development, skeletal and muscular system development and function, Ca signaling and the role of osteoblasts, osteoclasts and chondrocytes. Network analysis indicated 9 genes (Aldehyde dehydrogenase 1 family, member A1; Aquaporin 9; Interleukin 1 receptor accessory protein; Very low density lipoprotein receptor; Periostin, osteoblast specific factor; Aggrecan; Gremlin 1; Angiopoietin-like 4; Wingless-type MMTV integration site family, member 10B were hubs connected with tissue development and immunological diseases. These results suggest that chronic systemic inflammation might underlie the GX-induced pathological changes in bone.

  20. How to explant a diseased liver for living donor liver transplantation after previous gastrectomy with severe adhesion (with video).

    Science.gov (United States)

    Eguchi, Susumu; Soyama, Akihiko; Takatsuki, Mitsuhisa; Hidaka, Masaaki; Adachi, Tomohiko; Kitasato, Amane; Baimakhanov, Zhassulan; Kuroki, Tamotsu

    2014-08-01

    We performed living donor liver transplantation (LDLT) in a patient who had undergone distal gastrectomy for gastric ulcer disease with Billroth I reconstruction 30 years before the LDLT. The adhesion was very severe between remnant stomach and hepatic hilum as well as left liver lobe with shortening of hepatoduodenal structures. After dissection of the infrahepatic inferior vena cava, the Spiegel lobe was identified from the dorsal side. The Spiegel lobe was then penetrated with a right angle dissector so that a plastic tape could be placed around the whole adhesion, including important structures in the hepatoduodenal ligament. Next, the right hepatic vein was transected with a vascular stapler using Pringle's maneuver using the plastic tape to fasten the entire adhesional structure. Subsequently, the trunk of the middle and left hepatic vein was transected after clamping. The remaining short hepatic veins in the left side were divided completely from the cranial to the caudal direction to dissect Spiegel's lobe. Finally, the hepatoduodenal ligament was identified from the attached remnant stomach and the duodenum and a vascular clamp was placed on the entire hepatoduaodenal ligament. Finally, the diseased liver was explanted for graft implantation. Thus, retrograde explantation of the liver was effective in decreasing the risk of damaging vital elements in the hepatoduodenal ligament, the remnant stomach, and the duodenum.

  1. Percutaneous transhepatic duodenostomy for a gastrectomy case with CT guidance and real-time visualization by an ultrasound and endoscopy.

    Science.gov (United States)

    Moriwaki, Yoshihiro; Otani, Jun; Sawada, Yoshiyuki; Okuda, Junzo; Niwano, Toshiyuki; Ntta, Tachiko; Ohshima, Chiaki

    2015-09-01

    After gastrectomy, the remnant stomach, a small stomach behind the lateral segment of the liver, is thought to be a relative contraindication to receiving a percutaneous endoscopy-guided gastrostomy (PEG). We successfully performed a percutaneous duodenostomy in a case with remnant stomach. We used a transhepatic pull method with computed tomography (CT) guidance and real-time visualization by using ultrasound (US) and an endoscopy. The procedure was as follows: 1. Full stretching of the remnant stomach; 2. Insertion of a fine injection needle into the duodenal lumen through the lateral segment of the liver without an intrahepatic vascular and biliary injury using real-time visualization through US; 3. Confirmation of the location of the fine needle using abdominal CT, which showed the fine needle penetrating through the lateral segment and the duodenal lumen; 4. Insertion of the thick needle of the PEG kit just laterally of the fine needle; 5. Confirmation of the location of the thick needle using a repeated CT; 6. Endoscopic confirmation of the location of the two needles; 7. Changing the direction of the thick needle using guidance with endoscopy, inserting the thick needle into the duodenal lumen, and removing the fine needle; 8. Insertion of the guide wire through the thick needle; and 9. Placement of the PEG tube using the pull method. Using a real-time US scan, we detected the puncture of the anterior wall of the duodenum or stomach and avoided intrahepatic major vascular and biliary injuries.

  2. ZEBRAFISH CHROMOSOME-BANDING

    NARCIS (Netherlands)

    PIJNACKER, LP; FERWERDA, MA

    1995-01-01

    Banding techniques were carried out on metaphase chromosomes of zebrafish (Danio rerio) embryos. The karyotypes with the longest chromosomes consist of 12 metacentrics, 26 submetacentrics, and 12 subtelocentrics (2n = 50). All centromeres are C-band positive. Eight chromosomes have a pericentric C-b

  3. Stretch Band Exercise Program

    Science.gov (United States)

    Skirka, Nicholas; Hume, Donald

    2007-01-01

    This article discusses how to use stretch bands for improving total body fitness and quality of life. A stretch band exercise program offers a versatile and inexpensive option to motivate participants to exercise. The authors suggest practical exercises that can be used in physical education to improve or maintain muscular strength and endurance,…

  4. The Friction and Wear of Active Lubricants in theSleeve-ring Pair Lubricated by Presence of Magnetic Field

    Institute of Scientific and Technical Information of China (English)

    ZHOUQiang; LIJian-ping; LONGHong-sheng

    2004-01-01

    The effect of magnetic fteld on the tribological process of sleeve-ring pair lubricated by WRL lu-bricants was investigated by means of a NG-x wear tester and a PS5013 video microscope. The friction coefficient (f) and the wear weight(W) in lubricating test with WRL lubricant were decreased with the increase in the ,mag-netic field vertical to the rubbing surface, and an almost zero wear lubricating situation was gained in a magneticfield of 1000A/m. The captured wear micro particles on the rubbing surface were observed in the testing process,and the theoretical analysis of magnetic effects was completed. It is indicated that the magnetic field has not only a capturing action of wear micro particles on the worn surface, but also a inducing polarization0 of magnetic anisotropy of lubricant molecular. The actions promote the absorption of WRL lubricant into the wear swrface aswell as wear micro-particles, so that a good tribological effect is obtained when both magnetic field and WRL pr-esent.

  5. Iliotibial band friction syndrome.

    Science.gov (United States)

    Lavine, Ronald

    2010-07-20

    Published articles on iliotibial band friction syndrome have been reviewed. These articles cover the epidemiology, etiology, anatomy, pathology, prevention, and treatment of the condition. This article describes (1) the various etiological models that have been proposed to explain iliotibial band friction syndrome; (2) some of the imaging methods, research studies, and clinical experiences that support or call into question these various models; (3) commonly proposed treatment methods for iliotibial band friction syndrome; and (4) the rationale behind these methods and the clinical outcome studies that support their efficacy.

  6. 腹腔镜胃癌根治术与开腹胃癌根治术的临床分析%Clinical Analysis of Laparoscopic Gastrectomy and Open Gastrectomy for Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    贺赛奇; 谭曙光

    2015-01-01

    目的:通过比较腹腔镜下胃癌第二站淋巴结全部清除( D2根治术)与开腹胃癌D2根治手术的差异,探讨腹腔镜下胃癌D2根治术的可行性。方法分析本院202例胃癌D2根治手术患者的病例资料,其中腹腔镜下胃癌D2根治术(腹腔镜组)102例,开腹下胃癌D2根治术(开腹组)100例,比较两组患者的围术期的各项临床指标,进行统计学分析。结果腹腔镜下胃癌D2根治手术,无中转开腹病例,两组在年龄、性别、TNM分期、肿瘤直径、手术方式方面无统计差异。腹腔镜组手术切口长度,术中出血量,术后胃肠排气时间,术后开始进食时间,术后并发症发生率,术后住院时间较开腹组明显减少(P0.05)。结论腹腔镜胃癌D2根治术与开腹胃癌D2根治手术相比创伤小,术后恢复快,手术安全,手术疗效确切,近期结果相同,值得临床推广。%Objective The aim of the study was to compare the operative outcomes and adequacy between resection of laparoscopic D2 gastrectomy and open D2 gastrectomy for gastric. Methods 202 with cancer underwent D2 radical between January 2010 and December 2013 includes 102 patients underwent laparoscopic surgery( laparoscopy group) and 100 patients underwent traditional surgery( laparotomy group) . The intraoperative and postoperative condition between the two groups were compared. Results Two groups in age,sex,TNM stage,tumor diameter,the operation way were not statistically different. Laparoscopy group compared with laparotomy group decreased significantly (P<0. 05) in incision length,intraoperative blood loss,postoperative hospital stay,postoperative gastrointestinal exhaust time,postoperative start eating time,postoperative com-plications. Incision and distance of the tumor,the number of lymph node cleaning and recent results have no obvious statistical difference in two groups. Conclusion Laparoscopic D2 gastric cancer radical prostatectomy has

  7. Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer: Analysis from a Large-Scale Cohort.

    Science.gov (United States)

    Zhuang, Cheng-Le; Huang, Dong-Dong; Pang, Wen-Yang; Zhou, Chong-Jun; Wang, Su-Lin; Lou, Neng; Ma, Liang-Liang; Yu, Zhen; Shen, Xian

    2016-03-01

    Currently, the association between sarcopenia and long-term prognosis after gastric cancer surgery has not been investigated. Moreover, the association between sarcopenia and postoperative complications remains controversial. This large-scale retrospective study aims to ascertain the prevalence of sarcopenia and assess its impact on postoperative complications and long-term survival in patients undergoing radical gastrectomy for gastric cancer. From December 2008 to April 2013, the clinical data of all patients who underwent elective radical gastrectomy for gastric cancer were collected prospectively. Only patients with available preoperative abdominal CT scan within 30 days of surgery were considered for analysis. Skeletal muscle mass was determined by abdominal (computed tomography) CT scan, and sarcopenia was diagnosed by the cut-off values obtained by means of optimum stratification. Univariate and multivariate analyses evaluating risk factors of postoperative complications and long-term survival were performed. A total of 937 patients were included in this study, and 389 (41.5%) patients were sarcopenic based on the diagnostic cut-off values (34.9 cm²/m² for women and 40.8 cm²/m² for men). Sarcopenia was an independent risk factor for severe postoperative complications (OR = 3.010, P sarcopenia did not show significant association with operative mortality. Moreover, sarcopenia was an independent predictor for poorer overall survival (HR = 1.653, P sarcopenia remained an independent risk factor for overall survival and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. Sarcopenia is an independent predictive factor of severe postoperative complications after radical gastrectomy for gastric cancer. Moreover, sarcopenia is independently associated with overall and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I.

  8. Bariatric surgery - effects on obesity and related co-morbidities

    DEFF Research Database (Denmark)

    Svane, Maria Saur; Madsbad, Sten

    2014-01-01

    Laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (SG) are the three most commonly performed bariatric procedures. Obesity responds well to bariatric surgery, with major long-lasting weight loss that is most pronounced...... hormone responses, especially a 10-fold increase in glucagon-like peptide-1 (GLP-1), which improves insulin secretion. After gastric banding, the remission of diabetes depends more on weight loss. Bariatric surgery reduces cardiovascular risk factors including hypertension, lipid disturbances, non...

  9. Laparoscopic gastric banding

    Science.gov (United States)

    ... make the band tighter or looser any time after you have this surgery. It may be tightened or ... Having problems eating Not losing enough weight Vomiting after you eat Outlook (Prognosis) The final weight loss with ...

  10. CSF oligoclonal banding - slideshow

    Science.gov (United States)

    ... presentations/100145.htm CSF oligoclonal banding - series—Normal anatomy ... Overview The cerebrospinal fluid (CSF) serves to supply nutrients to the central nervous system (CNS) and collect waste products, as well as ...

  11. Long-term changes in bone mass after partial gastrectomy in a well-defined population and its relation to tobacco and alcohol consumption

    DEFF Research Database (Denmark)

    Krogsgaard, M R; Frølich, A; Lund, B

    1995-01-01

    alcohol consumption or cumulative tobacco consumption and bone mineral content in each group. Gastrectomized women smoked much more than control women, and smoking may be a determinant factor for the bone loss, as it is in healthy persons. Operated patients had a lower intake of milk products. All...... patients were exposed to sunlight for more than 3 hours/week. It is suggested that osteopenia after gastrectomy might be caused by calcium depletion rather than lack of vitamin D. The consumption of tobacco but not of alcohol was connected to bone loss....

  12. The Band Pass Filter

    OpenAIRE

    Christiano, Lawrence J.; Terry J. Fitzgerald

    1999-01-01

    The `ideal' band pass filter can be used to isolate the component of a time series that lies within a particular band of frequencies. However, applying this filter requires a dataset of infinite length. In practice, some sort of approximation is needed. Using projections, we derive approximations that are optimal when the time series representations underlying the raw data have a unit root, or are stationary about a trend. We identify one approximation which, though it is only optimal for one...

  13. Iliotibial band friction syndrome

    OpenAIRE

    Lavine, Ronald

    2010-01-01

    Published articles on iliotibial band friction syndrome have been reviewed. These articles cover the epidemiology, etiology, anatomy, pathology, prevention, and treatment of the condition. This article describes (1) the various etiological models that have been proposed to explain iliotibial band friction syndrome; (2) some of the imaging methods, research studies, and clinical experiences that support or call into question these various models; (3) commonly proposed treatment methods for ili...

  14. Photonic band gap materials

    Science.gov (United States)

    Cassagne, D.

    Photonic band gap materials Photonic band gap materials are periodic dielectric structures that control the propagation of electromagnetic waves. We describe the plane wave method, which allows to calculate the band structures of photonic crystals. By symmetry analysis and a perturbative approach, we predict the appearance of the low energy photonic band gaps of hexagonal structures. We propose new two-dimensional structures called graphite and boron nitride. Using a transfer matrix method, we calculate the transmission of the graphite structure and we show the crucial role of the coupling with external modes. We study the appearance of allowed modes in the photonic band gap by the introduction of localized defects in the periodicity. Finally, we discuss the properties of opals formed by self-organized silica microspheres, which are very promising for the fabrication of three-dimensional photonic crystals. Les matériaux à bandes interdites photoniques sont des structures diélectriques périodiques qui contrôlent la propagation des ondes électromagnétiques. Nous décrivons la méthode des ondes planes qui permet de calculer les structures de bandes des cristaux photoniques. Par une analyse de la symétrie et une approche perturbative, nous précisons les conditions d'existence des bandes interdites de basse énergie. Nous proposons de nouvelles structures bidimensionnelles appelées graphite et nitrure de bore. Grâce à une méthode de matrices de transfert, nous calculons la transmission de la structure graphite et nous mettons en évidence le rôle fondamental du couplage avec les modes extérieurs. Nous étudions l'apparition de modes permis dans la bande interdite grâce à l'introduction de défauts dans la périodicité. Enfin, nous discutons les propriétés des opales constituées de micro-billes de silice auto-organisées, qui sont très prometteuses pour la fabrication de cristaux photoniques tridimensionnels.

  15. Reinforcement of dented pipeline through composite sleeve repair systems subjected to fatigue by internal pressure; Reparos de dutos com amassamento atraves de luvas de materiais compositos submetidos a fadiga por pressao interna

    Energy Technology Data Exchange (ETDEWEB)

    Perrut, Valber Azevedo; Meniconi, Luiz Claudio de Marco [Centro de Pesquisas da Petrobras (CENPES). Gerencia de Tecnologia de Materiais, Equipamentos e Corrosao (Brazil)], e-mails: vperrut@petrobras.com.br, meniconi@petrobras.com.br; Souza Filho, Byron Goncalvez de [Transpetro (Brazil)], e-mail: byron.souza@petrobras.com.br

    2008-12-15

    Composite sleeve repair systems, now of widespread use in the market, were originally developed for the reinforcement of corroded pipelines. TRANSPETRO, the Brazilian pipeline operator, requested PETROBRAS/CENPES to address the behavior of sleeves when applied to dented pipelines. Simple verification experiments were carried out, in which both the dent filler material and the sleeve material were varied. Artificial dents with depths of 19% OD were imposed to 22 in. OD, 0.5 in. thick, API 5L X60 tubular specimens. Concrete and polymeric materials were tested for dent filler, whereas glass and carbon fiber composites, in two different thicknesses, were tried as the sleeve structural material. The main purpose of the repair sleeve in this case is to provide a repair procedure installed at low temperature and capable of reducing the stress range at the hot spot in the dent. The goal is to improve the fatigue resistance of the repaired pipeline. Low cycle fatigue tests were performed, both using non-repaired specimens (to serve as the basis for comparison) and specimens repaired using different schemes. The tests were fully instrumented to analyze strains in each specimen. After the fatigue tests, each specimen was pressurized until collapse, in order to quantify their ultimate strength. This paper reports the main results of the tests and the strain analysis for each repaired specimen, with the purpose of defining parameters which will serve to the design of future cases. (author)

  16. An investigation of the factors effecting high-risk individuals' decision-making about prophylactic total gastrectomy and surveillance for hereditary diffuse gastric cancer (HDGC).

    Science.gov (United States)

    Hallowell, Nina; Badger, Shirlene; Richardson, Sue; Caldas, Carlos; Hardwick, Richard H; Fitzgerald, Rebecca C; Lawton, Julia

    2016-10-01

    Hereditary diffuse gastric cancer has an early onset and poor prognosis, therefore, individuals who carry a pathogenic (CDH1) mutation in the E-cadherin gene (CDH1) are offered endoscopic surveillance and advised to undergo prophylactic total gastrectomy (PTG) in their early to mid-twenties. Patients not ready or fit to undergo gastrectomy, or in whom the genetic testing result is unknown or ambiguous, are offered surveillance. Little is known about the factors that influence decisions to undergo or decline PTG, making it difficult to provide optimal support for those facing these decisions. Qualitative interviews were carried out with 35 high-risk individuals from the Familial Gastric Cancer Study in the UK. Twenty-seven had previously undergone PTG and eight had been identified as carrying a pathogenic CDH1 mutation but had declined surgery at the time of interview. The interviews explored the experience of decision-making and factors influencing risk-management decisions. The data suggest that decisions to proceed with PTG are influenced by a number of potentially competing factors: objective risk confirmation by genetic testing and/or receiving a positive biopsy; perceived familial cancer burden and associated risk perceptions; perceptions of post-surgical life; an increasing inability to tolerate endoscopic procedures; a concern that surveillance could miss a cancer developing and individual's life stage. These findings have implications for advising this patient group.

  17. Banded transformer cores

    Science.gov (United States)

    Mclyman, C. W. T. (Inventor)

    1974-01-01

    A banded transformer core formed by positioning a pair of mated, similar core halves on a supporting pedestal. The core halves are encircled with a strap, selectively applying tension whereby a compressive force is applied to the core edge for reducing the innate air gap. A dc magnetic field is employed in supporting the core halves during initial phases of the banding operation, while an ac magnetic field subsequently is employed for detecting dimension changes occurring in the air gaps as tension is applied to the strap.

  18. Ultra wide band antennas

    CERN Document Server

    Begaud, Xavier

    2013-01-01

    Ultra Wide Band Technology (UWB) has reached a level of maturity that allows us to offer wireless links with either high or low data rates. These wireless links are frequently associated with a location capability for which ultimate accuracy varies with the inverse of the frequency bandwidth. Using time or frequency domain waveforms, they are currently the subject of international standards facilitating their commercial implementation. Drawing up a complete state of the art, Ultra Wide Band Antennas is aimed at students, engineers and researchers and presents a summary of internationally recog

  19. Colloquium: Topological band theory

    Science.gov (United States)

    Bansil, A.; Lin, Hsin; Das, Tanmoy

    2016-04-01

    The first-principles band theory paradigm has been a key player not only in the process of discovering new classes of topologically interesting materials, but also for identifying salient characteristics of topological states, enabling direct and sharpened confrontation between theory and experiment. This review begins by discussing underpinnings of the topological band theory, which involve a layer of analysis and interpretation for assessing topological properties of band structures beyond the standard band theory construct. Methods for evaluating topological invariants are delineated, including crystals without inversion symmetry and interacting systems. The extent to which theoretically predicted properties and protections of topological states have been verified experimentally is discussed, including work on topological crystalline insulators, disorder and interaction driven topological insulators (TIs), topological superconductors, Weyl semimetal phases, and topological phase transitions. Successful strategies for new materials discovery process are outlined. A comprehensive survey of currently predicted 2D and 3D topological materials is provided. This includes binary, ternary, and quaternary compounds, transition metal and f -electron materials, Weyl and 3D Dirac semimetals, complex oxides, organometallics, skutterudites, and antiperovskites. Also included is the emerging area of 2D atomically thin films beyond graphene of various elements and their alloys, functional thin films, multilayer systems, and ultrathin films of 3D TIs, all of which hold exciting promise of wide-ranging applications. This Colloquium concludes by giving a perspective on research directions where further work will broadly benefit the topological materials field.

  20. DUAL BAND MONOPOLE ANTENNA DESIGN

    Directory of Open Access Journals (Sweden)

    P. Jithu

    2013-06-01

    Full Text Available The WLAN and Bluetooth applications become popular in mobile devices, integrating GSM and ISM bands operation in one compact antenna, can reduce the size of mobile devices. Recently, lot many investigations are carried out in designing a dual band antennas with operating frequencies in GSM band and in ISM band for mobile devices. Printed monopoles are under this investigation. In this paper, dual-band printed monopoles are presented to operate at GSM band i.e. 900 MHz and ISM band i.e. 2.4 GHz. We intend to observe the antenna characteristics on the network analyzer and verify the theoretical results with the practical ones.

  1. 钻机配油套加工工艺技术的研究%On Processing Technology of the Oil Distribution Sleeve of Drilling Rig

    Institute of Scientific and Technical Information of China (English)

    杜渔舟

    2014-01-01

    联动系列钻机中关键零件配油套的设计要求高、生产难度大、报废率高,因此,为提高产品质量与生产效率,增强产品的市场竞争力,需深入研究钻机配油套加工工艺技术。通过不断的试验探索,研究出最适合自身产品的合理工艺。%As the key part of the linkage series of drilling rig, the oil distribution sleeve has high design requirement, difficult production, high rejection rate. So In order to improve the product quality and production efficiency, and enhance the competitiveness of products in the market, it's necessary to further research oil processing technology of oil distribution sleeve of drilling rig. Through continuous experiment, the paper aims to study the most suitable and reasonable process technology for own products.

  2. Small gap anastomosis to repair peripheral nerve rupture using a nerve regeneration chamber constructed by scissoring and sleeve jointing autologous epineurium

    Institute of Scientific and Technical Information of China (English)

    Peiji Wang; Zhongliang Zhou; Qirong Dong

    2011-01-01

    A number of studies have shown how to eliminate the misorientated docking of the peripheral nerve bundle in the traditional epineurium or perineudum anastomosis, thus avoiding neuroma formation and axonal outgrowth from the coaptation sites, and seriously hindering neural function recovery. Based on the "peripheral nerve selective regeneration theory", this experiment was designed to investigate the feasibility and benefits of a new small gap anastomosis repairing peripheral nerve rupture, by scissoring and sleeve jointing an autologous epineurium. In the proximal stump of the nerve, a 1 mm-long epineurium was annularly separated and removed, while a 3 mm-long epineurium was longitudinally incised in the distal stump after the epineurium was dissociated from proximal to distal. The epineuria of the two stumps and the longitudinal incision were sutured, leaving a 2 mm gap between the two nerve stumps. Results show that the experimental rats quickly recovered autonomic activities, and there were minimal adhesions at the outer surface of the epineurial tube to the surrounding tissue. The morphologic changes to the sciatic nerve showed that connective tissue hyperplasia of the small gaps was significantly reduced, and nerve fibers were arranged orderly. No such changes were observed in the neurorrhaphy in situ group. Thus, the experiment confirmed that the new small gap anastomosis to repair peripheral nerve rupture by scissoring and sleeve jointing autologous epineurium is feasible, and that it is superior to epineurium neurorrhaphy in situ.

  3. 镁合金轮椅小轮轴套焊接结构改进%Structure Improvement of Small Wheel Sleeve Welding on Mg Alloy Wheelchair

    Institute of Scientific and Technical Information of China (English)

    牛丽媛; 孙大仁; 林继兴; 华学兵

    2012-01-01

    The structure of small wheel sleeve welding on magnesium alloy wheelchair were investigated by altering small wheel sleeve welding position, and altering the location and direction of weld bead, which can contribute to the stress release, then the fatigue strength on the welding position was improved. The results show that there is a certain relationship between weld bead and fatigue strength, when the length of weld bead is more than 25 mm, the fatigue life can reach more than 210,000 times, which can meet wheelchair using requirements according to GB/T13800-2009.%研究了镁合金轮椅小轮轴套焊接部位的结构,改变了焊道的部位和方向,大大降低了焊接部位应力集中,有效地提高了焊接部位的疲劳强度.结果表明:焊道长度与疲劳性能有一定的关系,当焊道长度大于25mm时,其疲劳寿命可达21万次以上,根据GB/T 13800-2009标准测试满足轮椅的使用要求.

  4. Diffuse interstellar absorption bands

    Institute of Scientific and Technical Information of China (English)

    XIANG FuYuan; LIANG ShunLin; LI AiGen

    2009-01-01

    The diffuse interstellar bands (DIBs) are a large number of absorption bands that are superposed on the interstellar extinction curve and are of interstellar origin. Since the discovery of the first two DIBs in the 1920s, the exact nature of DIBs still remains unclear. This article reviews the history of the detec-tions of DIBs in the Milky Way and external galaxies, the major observational characteristics of DIBs, the correlations or anti-correlations among DIBs or between DIBs and other interstellar features (e.g. the prominent 2175 Angstrom extinction bump and the far-ultraviolet extinction rise), and the proposed candidate carriers. Whether they are also present in circumstellar environments is also discussed.

  5. Diffuse interstellar absorption bands

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The diffuse interstellar bands(DIBs) are a large number of absorption bands that are superposed on the interstellar extinction curve and are of interstellar origin. Since the discovery of the first two DIBs in the 1920s,the exact nature of DIBs still remains unclear. This article reviews the history of the detections of DIBs in the Milky Way and external galaxies,the major observational characteristics of DIBs,the correlations or anti-correlations among DIBs or between DIBs and other interstellar features(e.g. the prominent 2175 Angstrom extinction bump and the far-ultraviolet extinction rise),and the proposed candidate carriers. Whether they are also present in circumstellar environments is also discussed.

  6. Significance of modified Lawrence's reconstuction procedures following total gastrectomy for gastric cancer%全胃切除改良Lawrence法消化道重建的意义

    Institute of Scientific and Technical Information of China (English)

    邹小明; 宋茂力; 聂刚; 李刚; 佟佰峰; 姜浩

    2011-01-01

    目的 探讨胃癌全胃切除术改良Lawrence法消化道重建对患者营养吸收的影响.方法 对76例全胃切除患者,行改良Lawrence法消化道重建3个月和6个月的营养状况及消化道症状进行回顾性分析.结果 76例患者中48例患者于术后3个月行钡餐检查,钡剂排空时间为60~100 min,站立位与平卧位均未见钡剂反流入食管,无吻合口狭窄的征象.分别于术后3个月和6个月复查血红蛋白、总蛋白、体重、进食量,均达到或接近术前水平.结论 该术式使患者在术后短期内恢复正常饮食习惯,手术操作简便、安全,是全胃切除术后一种理想的消化道重建术式.%Objective To explore the influence of modified Lawrence's reconstuction procedures following total gastrectomy for gastric cancer to alimentation of patients. Methods Retrospective analysis of nutritional status and symptoms of digestive tract in 76 patiens of total gastrectomy for gastric cancer while 3 and 6 month after modified Lawrence's reconstuction procedure. Results Examination was given in 48 patients 3 month after operation. Emptying time of barium was 60-100 min, barium meal backflowing to esophagus was not observed in all patients when they were in erect or decubitus position, no sign of narrow of anastomotic stoma. The hemoglobin, total protein, body weight and food-intake of patients 3 or 6 months after operation was as same as them before operation. Conclusion The patients undergoing this reconstuction procedure will recover normal food habits soon after operation, Lawrence's reconstuction procedures is a satisfactory choice in patients of total gastrectomy for gastric cancer because of its safety and convenient.

  7. Long-term effects of gastrectomy in patients with spirometry-defined COPD and patients at risk of COPD: a case-control study

    Directory of Open Access Journals (Sweden)

    Saito H

    2015-10-01

    Full Text Available Hitoshi Saito,1,2 Koichiro Nomura,1,2,† Shinji Abe,1,2 Takashi Motegi,2,3 Takeo Ishii,2,3 Kumiko Hattori,2,3 Yuji Kusunoki,2,3 Akihiko Gemma,2 Kozui Kida2,3 1Department of Respiratory Medicine, Tokyo Metropolitan Hiroo Hospital, 2Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan, 3Respiratory Care Clinic, Nippon Medical School †Koichiro Nomura passed away on July 30, 2014 Objective: Comorbidities are characteristic of COPD. However, little is known about the secondary manifestations of COPD in the gastrointestinal tract. Therefore, we aimed to explore the long-term effects of gastrectomy in patients with spirometry-defined COPD or those at risk of COPD.Participants: Subjects included 87 patients either with COPD or at risk of COPD (symptomatic who underwent gastrectomy between December 2003 and October 2013 (group A, and 174 patients either with COPD or at risk of COPD, matched by age (±5 years, sex, and forced expiratory volume in 1 second (FEV1 as percentage of predicted (FEV1% predicted (±5% (group B.Methods: All patients underwent routine blood chemistry and pulmonary function tests, arterial blood gas analysis, 6-minute walk test (6MWT, high-resolution chest computed tomography scans, and nutritional assessments.Results: The mean duration postgastrectomy was 18.3±15.4 years. The mean FEV1 and FEV1% predicted were 2.07±0.76 L and 74.6±24.5%, respectively. Univariate analysis indicated that group A patients had significantly lower body mass index, fat-free mass index, and serum hemoglobin and albumin concentration (all P=0.00, and walked a significantly shorter distance in the 6MWT (P<0.05. Multivariate linear regression analysis for the distance in the 6MWT indicated that increased residual volume (RV to total lung capacity (TLC as percentage of predicted (%RV/TLC alone was an independent and significant predictor of reduced distances in the 6MWT.Conclusion: We concluded

  8. Micromechanics of shear banding

    Energy Technology Data Exchange (ETDEWEB)

    Gilman, J.J.

    1992-08-01

    Shear-banding is one of many instabilities observed during the plastic flow of solids. It is a consequence of the dislocation mechanism which makes plastic flow fundamentally inhomogeneous, and is exacerbated by local adiabatic heating. Dislocation lines tend to be clustered on sets of neighboring glide planes because they are heterogeneously generated; especially through the Koehler multiple-cross-glide mechanism. Factors that influence their mobilities also play a role. Strain-hardening decreases the mobilities within shear bands thereby tending to spread (delocalize) them. Strain-softening has the inverse effect. This paper reviews the micro-mechanisms of these phenomena. It will be shown that heat production is also a consequence of the heterogeneous nature of the microscopic flow, and that dislocation dipoles play an important role. They are often not directly observable, but their presence may be inferred from changes in thermal conductivity. It is argued that after deformation at low temperatures dipoles are distributed a la Pareto so there are many more small than large ones. Instability at upper yield point, the shapes of shear-band fronts, and mechanism of heat generation are also considered. It is shown that strain-rate acceleration plays a more important role than strain-rate itself in adiabatic instability.

  9. Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass for the Management of morbid obesity: a Meta-analysis of randomized controlled trials%腹腔镜胃袖套状切除术与Roux-en-Y 胃肠短路术治疗肥胖的随机对照试验研究Meta 分析

    Institute of Scientific and Technical Information of China (English)

    杜弢; 王国强; 李小维; 李万根

    2012-01-01

    系统评价腹腔镜胃袖套状切除术(LSG)与腹腔镜Roux-en-Y 胃肠短路术(LRYGB)两种术式对肥胖患者的疗效及其临床应用价值.通过Pubmed、Embase、Springerlink、万方和CNKI 数据库检索LSG 与LRYGB 两种术式治疗肥胖的随机对照研究文献,文献检索时间截止至2012 年4 月.共纳入6 篇随机对照试验研究文献,Meta 分析的结果显示两术式对术后患者体重指数、额外体重丢失、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、HbA1c、空腹血糖、胰岛素和HOMAIR的影响均无统计学差异(P>0.05).LSG 与LRYGB 作为外科治疗肥胖的两种常用术式,两者在术后体重、血糖、血脂的控制效果相当,提示LSG 可作为外科治疗肥胖的主要术式之一.

  10. Semiconductors bonds and bands

    CERN Document Server

    Ferry, David K

    2013-01-01

    As we settle into this second decade of the twenty-first century, it is evident that the advances in micro-electronics have truly revolutionized our day-to-day lifestyle. The technology is built upon semiconductors, materials in which the band gap has been engineered for special values suitable to the particular application. This book, written specifically for a one semester course for graduate students, provides a thorough understanding of the key solid state physics of semiconductors. It describes how quantum mechanics gives semiconductors unique properties that enabled the micro-electronics revolution, and sustain the ever-growing importance of this revolution.

  11. Band-Notched Ultrawide Band Planar Inverted-F Antenna

    Directory of Open Access Journals (Sweden)

    H. T. Chattha

    2012-01-01

    Full Text Available A novel ultrawide band planar inverted-F antenna with band-notched characteristics is presented in this paper. The planar inverted-F antenna uses two parasitic elements to enhance the bandwidth to cover the ultrawide band. The band-notched feature is added by inserting a W-shaped slot on the top radiating element of the antenna with a band rejection from 5.08 to 6 GHz (measured. Both the measured and simulated results are obtained to draw the conclusions.

  12. 腹腔镜手术治疗残胃癌7例分析%Laparoscopic gastrectomy for gastric stump cancer:analysis of 7 cases

    Institute of Scientific and Technical Information of China (English)

    张人超; 徐晓武; 牟一平; 周育成; 周家瑜; 黄超杰; 许芸芸

    2016-01-01

    目的:探讨腹腔镜手术治疗残胃癌的安全性和可行性。方法回顾性分析2008年1月至2015年7月间在浙江省人民医院胃肠胰外科接受腹腔镜手术治疗的7例残胃癌患者的临床和随访资料。结果7例患者中男性5例,女性2例;年龄(62.1±10.7)岁;胃良性病变术后残胃癌4例,距胃首次手术时间6~30年;胃癌术后残胃再发癌3例,距胃首次手术时间11~15年。首次手术行BillrothⅡ术式者6例,Roux-en-Y术式者1例。本次手术分离腹腔粘连及探查腹腔后确定肿瘤位置后,行残胃切除加淋巴清扫术,然后进行食管空肠Roux-en-Y吻合。1例使用圆形吻合器行食管空肠端侧吻合;2例使用内镜直线切割闭合器食管空肠侧侧吻合;4例行手工缝合食管空肠吻合。手术时间(247.1±17.5) min;术中出血量(100.0±30.8) ml;术中均未输血。淋巴结清扫(19.1±4.8)枚。术后肛门排气时间(3.3±1.5) d;进食流质时间(3.7±0.8) d,住院时间(9.4±2.6) d。1例患者术后出现消化道出血,保守治疗后痊愈;无围手术期死亡者。术后7例均获得随访,随访时间截至2016年1月。随访6~38月。1例术后17月死于腹腔转移,1例术后19月死于阿尔茨海默病。存活的5例至今无肿瘤复发或转移。结论腹腔镜手术治疗残胃癌安全可行。%Objective To evaluate the safety and feasibility of laparoscopic gastrectomy for gastric stump cancer. Methods Clinical and follow-up data of 7 patients who underwent laparoscopic gastrectomy for gastric stump cancer in our department from January 2008 to July 2015 were analyzed retrospectively. Results There were 5 male and 2 female patients, with a mean age of (62.1 ±10.7) years. Initial gastrectomy was performed for gastric cancer in 3 patients and peptic ulceration in 4. The initial surgery was B-Ⅱ gastrojejunostomy in 6 patients and Roux-en-Y gastrojejunostomy in 1

  13. 正挤横轧式农用车后桥半轴套管的研究开发%Study and Development of the Rear Axle Shaft Sleeves of Farm Transport Vehicle by Forward Extrusion and Cross Rolling

    Institute of Scientific and Technical Information of China (English)

    韩英淳; 王学明; 唐志强

    2001-01-01

    在成功地开发轻型车正挤与横轧式后桥半轴套管的基础上,自主开发了1608型、2310型及2815型农用运输车的正挤与横轧式后桥半轴套管,并实现系列化规模生产,获得了显著的社会经济效益。%On the basis of the development of the rear axle shaft sleeve of the light truck CA1040 by forward extrusion and cross rolling, to adapt to the rapid growth of farm transport vehicle, the rear axle shaft sleeve of farm transport vehicle 1608,2310,2815 have been developed successively and manufactured on a big scale. In accordance with the characteristic in geometrical shape of the rear axle shaft sleeve, we change it into a detached structure based on the equal strength theory. Since the detached sleeve bodies have a small difference in diameter, they can be formed with technology of the forward extrusion and cross rolling.

  14. DEFINITION OF DENSITY OF THE THERMAL STATIONARY STREAMS ON A SURFACES OF A SLEEVE OF CYLINDER COMBUSTION ENGINE BY A METHOD OF OPTIMUM FILTRATION KALMANA

    Directory of Open Access Journals (Sweden)

    ZARENBIN V. G.

    2016-01-01

    Full Text Available Problem statement. At research warmly intensity and thermal weariness of internal combustion engines (ICE the knowledge and the analysis of local temperatures and thermal streams in the basic details forming the chamber of combustion is defining. Theoretically the problem consists in the decision of the equation of heat conductivity at the set features of course of thermal processes on border of bodies. Thus there is a problem of accuracy of the decision since it depends on accuracy of the task of real boundary conditions which can be received only by means of physical experiment and corresponding metrological maintenance. Unlike temperature the thermal stream cannot be measured directly, therefore it define on a difference of temperatures (thermal gradient a method or a calorimetric method. Definition of density of streams with the help as named gauges of a thermal stream when the measured temperatures are used at the decision of a return problem of heat conductivity for chosen thermometric an element is most extended. In this case, except the requirement of one-dimensionality of distribution of temperatures, linearity and the minimum distortion of temperature fields of thermal system, there are considerable difficulties of calculation derivative of the measured temperature. To perspective it is possible to carry methods of researches which it is accepted to name cybernetic diagnostics or identification of systems. Their essence consists that the deformed information on object is compared to its mathematical model and then are defined its condition, parameters or entrance influences by minimization of square-law function are nonviscous. In work definition of density of thermal stationary streams on surfaces of a sleeve of cylinder ICE by a method of optimum filtration Kalmana and also an estimation of their reliability and accuracy is made. Possibility of application of filtration Kalmana is shown at experimental researches in ICE. The purpose

  15. 离心铸造大型厚壁钢套用涂料变质的研制%Development of Subnano Particles Modificational Function Coating and its Application in Steel Sleeve

    Institute of Scientific and Technical Information of China (English)

    张征

    2013-01-01

    Through compound modification treatment for coating with help of adding sub-nano RE alloy and alkali metal salt during centrifugal casting thick-walled casting steel sleeve, the solidification sequence of the steel sleeve could be controlled to reduce the undercooled rate of outer solidification of steel sleeve and refine grain size as well as controlling the directional growth of carbide in the steel sleeve, resolving the problems of thermal transferring during solidification process and eliminating the presence of crack. Based on the Lewis acid-base theory from the chemical point of view,the modification mechanism of the cerium-based rare earth alloy on steel was analyzed. The sulfur content in the steel sleeve was controlled . Subnano particles can greatly increase the number of heterogeneous nucleation substrate, and further reduce the solidification undercooling of outer steel sleeve as well as improving the coating suspension. After the steel sleeve solidified, the collapsed coating can be reclaimed, realizing green casting.%在离心铸造厚壁大型钢套时,在涂料中引入稀土合金及碱金属盐复合变质剂,可减小钢套外层凝固所需的过冷度、细化晶粒、控制碳化物单一方向生长,解决凝固过程中热传导瓶颈问题,避免热裂纹产生.根据路易斯酸碱理论,从化学角度对以铈为主的稀土合金变质机理进行探讨.并对钢套硫含量控制水平进行界定.亚纳米稀土颗粒引入极大增加异质形核衬底数,进一步减小钢套外层凝固的过冷度,同时也改善了涂料的悬浮性.钢套凝固后,溃落的涂层可回用,实现绿色铸造.

  16. The Oxygen a Band

    Science.gov (United States)

    Benner, D. Chris; Devi, V. Malathy; Hoo, Jiajun; Hodges, Joseph; Long, David A.; Sung, Keeyoon; Drouin, Brian; Okumura, Mitchio; Bui, Thinh Quoc; Rupasinghe, Priyanka

    2014-06-01

    The oxygen A band is used for numerous atmospheric experiments, but spectral line parameters that sufficiently describe the spectrum to the level required by OCO2 and other high precision/accuracy experiments are lacking. Fourier transform spectra from the Jet Propulsion Laboratory and cavity ring down spectra from the National Institute of Standards and Technology were fitted simultaneously using the William and Mary multispectrum nonlinear least squares fitting technique into a single solution including the entire band. In addition, photoacoustic spectra already available from the California Institute of Technology will be added to the solution. The three types of spectrometers are complementary allowing the strengths of each to fill in the weaknesses of the others. With this technique line positions, intensities, widths, shifts, line mixing, Dicke narrowing, temperature dependences and collision induced absorption have been obtained in a single physically consistent fit. D. Chris Benner, C. P. Rinsland, V. M. Devi, M. A. H. Smith, and D. Atkins, JQSRT 1995;53:705-21. Part of the research described in this paper was performed at The College of William and Mary, the, Jet Propulsion Laboratory, California Institute of Technology, under contracts and cooperative agreements with the National Aeronautics and Space Administration and the Jet Propulsion Laboratory. Support for the National Institute of Standards and Technology was provided by the NIST Greenhouse Gas Measurements and Climate Research Program and a NIST Innovations in Measurement Science (IMS) award.

  17. [Strategy and critical analysis of bariatric surgery].

    Science.gov (United States)

    Houben, J J; Barea, M; Maroquin, L; Isabo, O; Desmarets, A

    2007-09-01

    Bariatric surgery has considerably developed during the last 20 years in Belgium. The increase of prevalence of the morbid obesity and the development of multiple surgical procedures widened the spectrum of treatment. If a rigorous selection and a multidisciplinary approach of the patients are inescapable, the various decision-making algorithms plunge the practitioner into a certain confusion. The purpose of this paper is to clarify the advantages and the inconveniences of the different surgical treatments in light of the evolution of the principles and the objective results of the literature. Among the techniques proven and validated in the long run, one can mention the Silastic Ring Vertical Gastroplasty according to Mac Lean by minilaparotomy, the laparoscopic adjustable ring and the more recent gastric by pass. The evaluation of laparoscopic sleeve gastrectomy, and of duodenal switch is on course. The bilio-pancreatic by-pass according to Scopinaro remains strongly controversed. A meta-analysis of the literature confirms the success of the gastric bypass. Regarding to the long term follow-up, the adjustable gastric banding deceives. The sleeve gastrectomy should be analyzed in the long term. The preliminary results of a epidemiologic and financial study within a private hospital of Brussels reveals that the cost effective ratio is in favor the Silastic Ring Vertical Gastroplasty and the laparoscopic adjustable banding, as well in terms of public health support than the charge for the private insurance and the patient. The projection beyond 5 years reverses the tendency to plead in favor of the gastric by-pass. First with the hit-parade of comfort, food diversification, tolerance, gastro-esophageal reflux, and undoubtedly of the rate of recurrence, it supplants the others techniques for sweet eaters. The volume eaters can profit from a sleeve gastrectomy which undoubtedly supplants the Silastic Ring Vertical Gastroplasty responsible for late annular stenoses and

  18. Nonlinear FEA of interference fit of roll sleeve and roll shaft in roll forming machine%对辊成型机辊套辊轴过盈配合的有限元非线性分析

    Institute of Scientific and Technical Information of China (English)

    刘正魁; 张孟辉; 崔郎郎; 李聪杰; 史宝龙; 王林; 张发展

    2013-01-01

    对辊成型机的关键部件成型辊部件是采用辊轴和辊套的过盈配合来转递动力的,过盈量的选择对成型辊辊套的使用寿命起着重要的作用.针对辊套经常开裂的情况,对辊轴、辊套的过盈配合进行有限元ANSYS非线性分析,比较两种不同的约束条件,得出正确的约束条件.用ANSYS非线性分析辊套辊轴的等效应力、变形量和接触压力,并和辊轴、辊套过盈配合的传统理论计算进行比较,分析开裂的原因,确定适当的过盈量,为设计提供一定的借鉴.%As the key component of the roll forming machine,the forming roll assembly transmit the power via the interference fit of the roll shaft and the roll sleeve,and the interference amount plays an important role in the service lifespan of the roll sleeve.In view of frequent cracking of the roll sleeve,the paper conducted nonlinear FEA of the interference fit of the roll shaft and the roll sleeve,and achieved appropriate constraints after contrasting two kinds of constraints.ANSYS was applied to carry out nonlinear analysis on the equivalent stress,deformation and contact of the roll sleeve and the roll shaft,and then which were contrasted with the ones calculated by traditional theory.At last,the cracking causes were analyzed,and appropriate interference amount was determined,which offered some references for the design.

  19. Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava

    Directory of Open Access Journals (Sweden)

    Daxing ZHU

    2015-11-01

    Full Text Available A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department. Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor. Chest contrast computed tomography revealed the tumor invaded right pulmonary artery, superior vena cava, and the persistant left superior vena cava flowed into the coronary sinus. The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava (SVC utilizing ringed polytetrafluoroethylene graft. To the best of our knowledge, this was the first report of complete resection of locally advanced lung cancer involving superior vena cava, right pulmonary artery trunk and main bronchus with persistant left superior vena cava.

  20. A schwannoma of the S1 dural sleeve was resected while the intact nerve fibers were preserved using a microscope. Report of a case with early MRI findings.

    Science.gov (United States)

    Kobayashi, S; Uchida, K; Kokubo, Y; Yayama, T; Nakajima, H; Inukai, T; Nomura, E; Baba, H

    2007-04-01

    In this report, we describe a small schwannoma of the dural sleeve and mention that it is often difficult to differentiate this tumor from lumbar disc herniation, especially a sequestered hernia, or a discal cyst. Gadolinium-enhanced MR images were a useful preoperative examination modality for differentiating this lesion from other diseases. Microscopically, the intradural tumor was successfully removed. The dura mater of the S1 nerve root was opened microsurgically, allowing the nerve fibers involved in the tumor to be identified. The involved fibers were cut around the tumor, and the lesion was resected while the intact nerve fibers were preserved. Based on histological examination of the resected specimen, the tumor was diagnosed as a schwannoma with multilocular cystic degeneration. Microsurgery allowed the tumor to be removed with minimal impairment from cutting of nerve fibers in the nerve root. PMID:17674301

  1. Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava

    Institute of Scientific and Technical Information of China (English)

    Daxing ZHU; Xiaoming QIU; Qinghua ZHOU

    2015-01-01

    A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department. Bronchoscopy displayed complete obstruction of right upper lobe bronchus and inifltration of the bronchus intermedius with tumor. Chest contrast computed tomography revealed the tumor invaded right pulmonary artery, superior vena cava, and the persistant letf superior vena cava lfowed into the coronary sinus. hTe tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava (SVC) utilizing ringed polytetralfuoroethylene gratf. To the best of our knowledge, this was the ifrst report of complete resection of locally advanced lung cancer involving superior vena cava, right pulmonary artery trunk and main bronchus with persistant letf superior vena cava.

  2. Sleeve bridging of the rhesus monkey ulnar nerve with muscular branches of the pronator teres:multiple ampliifcation of axonal regeneration

    Institute of Scientific and Technical Information of China (English)

    Yu-hui Kou; Pei-xun Zhang; Yan-hua Wang; Bo Chen; Na Han; Feng Xue; Hong-bo Zhang; Xiao-feng Yin; Bao-guo Jiang

    2015-01-01

    Multiple-bud regeneration,i.e., multiple amplification, has been shown to exist in peripheral nerve regeneration. Multiple buds grow towards the distal nerve stump during proximal nerve ifber regeneration. Our previous studies have veriifed the limit and validity of multiple ampli-ifcation of peripheral nerve regeneration using small gap sleeve bridging of small donor nerves to repair large receptor nerves in rodents. The present study sought to observe multiple ampli-ifcation of myelinated nerve ifber regeneration in the primate peripheral nerve. Rhesus monkey models of distal ulnar nerve defects were established and repaired using muscular branches of the right forearm pronator teres. Proximal muscular branches of the pronator teres were su-tured into the distal ulnar nerve using the small gap sleeve bridging method. At 6 months after suture, two-ifnger lfexion and mild wrist lfexion were restored in the ulnar-sided injured limbs of rhesus monkey. Neurophysiological examination showed that motor nerve conduction veloc-ity reached 22.63 ± 6.34 m/s on the affected side of rhesus monkey. Osmium tetroxide staining demonstrated that the number of myelinated nerve fibers was 1,657 ± 652 in the branches of pronator teres of donor, and 2,661 ± 843 in the repaired ulnar nerve. The rate of multiple ampliifcation of regenerating myelinated nerve ifbers was 1.61. These data showed that when muscular branches of the pronator teres were used to repair ulnar nerve in primates, effective regeneration was observed in regenerating nerve ifbers, and functions of the injured ulnar nerve were restored to a certain extent. Moreover, multiple ampliifcation was subsequently detected in ulnar nerve axons.

  3. Duodenojejunostomia látero-lateral: uma alternativa cirúrgica para o tratamento do "dumping" pós gastrectomia Side to side duodenojejunostomy: a surgical alternative for dumping after gastrectomy

    Directory of Open Access Journals (Sweden)

    Elizabeth Gomes dos Santos

    2004-04-01

    Full Text Available Most patients with partiaI gastrectomy have no postoperative problems. Some of them, however, develop severe nutritional disturbance, particularly those with Bilroth II reconstruction, which can be treated clinically in the majority of the cases. Those with important mal absorptive problems require surgery. In this article we present a technical alternative for those patients who need reintervention over a BII operation. Our technique has the advantage of not touching the duodenum previously sutured.

  4. Impact of minimally invasive/bariatric surgery fellowship on perioperative complications and outcomes in the first year of practice

    Directory of Open Access Journals (Sweden)

    Iswanto Sucandy

    2013-01-01

    Full Text Available Background: Several reports have described worse perioperative outcomes of laparoscopic gastric bypass procedure during learning curve, which improved after completion of one-year fellowship training. Aims: The aim of this study was to evaluate the immediate impact of fellowship training on perioperative complications and outcomes of various bariatric procedures. Materials and Methods: One hundred initial patients who underwent laparoscopic gastric banding, laparoscopic Roux-en-Y gastric bypass, laparoscopic vertical sleeve gastrectomy, and robotically-assisted laparoscopic biliopancreatic diversion with duodenal switch by a single fellowship trained surgeon were analyzed. Results: Overall average Body Mass Index (BMI of the patients was 45.9 kg/m 2 , age was 47.5 years, and the American Society of Anesthesiologist Score was 2.89. There were no intraoperative, major 30-day complications, or open conversions. Average operative time was 62 minutes in gastric banding, 160 minutes in gastric bypass, 119 minutes in vertical sleeve gastrectomy, and 320 minutes in biliopancreatic diversion. Length of stay ranged from 0.5 day after gastric banding to 3.9 days after biliopancreatic diversion. The perioperative complications and outcomes are comparable with those reported by experienced surgeons. No mortality occurred in this series. Conclusions: Bariatric fellowship ensured skills acquisition for new surgeons to safely and effectively perform various types of bariatric operations, with minimal perioperative complications and excellent outcomes.

  5. Combustion-driven oscillation in a furnace with multispud-type gas burners. 4th Report. Effects of position of secondary air guide sleeve and openness of secondary air guide vane on combustion oscillation condition; Multispud gata gas turner ni okeru nensho shindo. 4. Nijigen kuki sleeve ichi oyobi nijigen kuki vane kaido no shindo reiki ni oyobosu eikyo

    Energy Technology Data Exchange (ETDEWEB)

    Akiyama, I.; Okiura, K.; Baba, A.; Orimoto, M. [Babcock-Hitachi K.K., Tokyo (Japan)

    1994-07-25

    Effects of the position of a secondary air guide sleeve and the openness of a secondary air guide vane on combustion oscillation conditions were studied experimentally for multispud-type gas burners. Pressure fluctuation in furnaces was analyzed with the previously reported resonance factor which was proposed as an index to represent the degree of combustion oscillation. As a result, the combustion oscillation region was largely affected by both position of a guide sleeve and openness of a guide vane. As the openness having large effect on the ratio of primary and secondary air/tertiary air and the position hardly having effect on the ratio were adjusted skillfully, the burner with no combustion oscillation region was achieved in its normal operation range. In addition, as the effect of preheating combustion air was arranged with a standard flow rate or mass flow flux of air, it was suggested the combustion oscillation region due to preheating can be described with the same manner as that due to no preheating. 5 refs., 8 figs.

  6. Medline Plus

    Full Text Available ... Center, Miami, FL, 12/4/2013) Surgical Weight Loss: Sleeve Gastrectomy ... Aiding in a Faster Return to Patient Quality-of-Life (Washington University School of Medicine in St. Louis, ...

  7. Mechanisms of surgical control of type 2 diabetes

    DEFF Research Database (Denmark)

    Holst, Jens Juul; Madsbad, Sten

    2016-01-01

    responsible for postprandial hypoglycemia sometimes observed after bypass. Other operations (biliopancreatic-diversion and or sleeve gastrectomy) appear to involve different and/or additional mechanisms, and so does experimental bariatric surgery in rodents. However, unlike bypass surgery in humans...

  8. Flat Bands Under Correlated Perturbations

    OpenAIRE

    Bodyfelt, Joshua D.; Leykam, Daniel; Danieli, Carlo; Yu, Xiaoquan; Flach, Sergej

    2014-01-01

    Flat band networks are characterized by coexistence of dispersive and flat bands. Flat bands (FB) are generated by compact localized eigenstates (CLS) with local network symmetries, based on destructive interference. Correlated disorder and quasiperiodic potentials hybridize CLS without additional renormalization, yet with surprising consequencies: (i) states are expelled from the FB energy $E_{FB}$, (ii) the localization length of eigenstates vanishes as $\\xi \\sim 1 / \\ln (E- E_{FB})$, (iii)...

  9. Theoretical Simulation for Identical Bands

    Institute of Scientific and Technical Information of China (English)

    CHEN Yong-Jing; CHEN Yong-Shou; GAO Zao-Chun

    2004-01-01

    @@ The frequency of occurrence of identical bands is studied by analysing a large number of rotational bands calculated with the reflection asymmetric shell model, and the statistical properties of identical bands indicated in all the experimental observations are reproduced within the mean field approximation and beyond mean field treatment, such as angular momentum projection. The distributions of the calculated J(2), Eγ and the fractional change of J(2) are discussed.

  10. Cluster banding heat source model

    Institute of Scientific and Technical Information of China (English)

    Zhang Liguo; Ji Shude; Yang Jianguo; Fang Hongyuan; Li Yafan

    2006-01-01

    Concept of cluster banding heat source model is put forward for the problem of overmany increment steps in the process of numerical simulation of large welding structures, and expression of cluster banding heat source model is deduced based on energy conservation law.Because the expression of cluster banding heat source model deduced is suitable for random weld width, quantitative analysis of welding stress field for large welding structures which have regular welds can be made quickly.

  11. Development of Wide Band Feeds

    Science.gov (United States)

    Ujihara, H.; Ichikawa, R.

    2012-12-01

    Wide Band feeds are being developed at NICT, NAOJ, and some universities in Japan for VLBI2010, SKA, and MARBLE. SKA, the Square Kilometre Array, will comprise thousands of radio telescopes with square kilometer aperture size for radio astronomy. MARBLE consists of small portable VLBI stations developed at NICT and GSI in Japan. They all need wide band feeds with a greater than 1:10 frequency ratio. Thus we have been studying wide band feeds with dual linear polarization for these applications.

  12. Improved Band-to-Band Registration Characterization for VIIRS Reflective Solar Bands Based on Lunar Observations

    Directory of Open Access Journals (Sweden)

    Zhipeng Wang

    2015-12-01

    Full Text Available Spectral bands of the Visible Infrared Imaging Radiometer Suite (VIIRS instrument aboard the Suomi National Polar-orbiting Partnership (S-NPP satellite are spatially co-registered. The accuracy of the band-to-band registration (BBR is one of the key spatial parameters that must be characterized. Unlike its predecessor, the Moderate Resolution Imaging Spectroradiometer (MODIS, VIIRS has no on-board calibrator specifically designed to perform on-orbit BBR characterization. To circumvent this problem, a BBR characterization method for VIIRS reflective solar bands (RSB based on regularly-acquired lunar images has been developed. While its results can satisfactorily demonstrate that the long-term stability of the BBR is well within ±0.1 moderate resolution band pixels, undesired seasonal oscillations have been observed in the trending. The oscillations are most obvious between the visible/near-infrared bands and short-/middle wave infrared bands. This paper investigates the oscillations and identifies their cause as the band/spectral dependence of the centroid position and the seasonal rotation of the lunar images over calibration events. Accordingly, an improved algorithm is proposed to quantify the rotation and compensate for its impact. After the correction, the seasonal oscillation in the resulting BBR is reduced from up to 0.05 moderate resolution band pixels to around 0.01 moderate resolution band pixels. After removing this spurious seasonal oscillation, the BBR, as well as its long-term drift are well determined.

  13. Iliotibial band Z-lengthening.

    Science.gov (United States)

    Richards, David P; Alan Barber, F; Troop, Randal L

    2003-03-01

    Iliotibial band friction syndrome (ITBFS) is a common overuse injury reported to afflict 1.6% to 12% of runners. It results from an inflammatory response secondary to excessive friction that occurs between the lateral femoral epicondyle and the iliotibial band. Initial treatments include rest, anti-inflammatory medication, modalities (ice or heat), stretching, physical therapy, and possibly a cortisone injection. In recalcitrant cases of ITBFS, surgery has been advocated. This report describes a surgical technique of Z-lengthening of the iliotibial band in patients presenting with lateral knee pain localized to the iliotibial band at the lateral femoral epicondyle and Gerdy's tubercle who failed all nonoperative efforts.

  14. Garage Band or GarageBand[R]? Remixing Musical Futures

    Science.gov (United States)

    Vakeva, Lauri

    2010-01-01

    In this paper, I suggest that it is perhaps time to consider the pedagogy of popular music in more extensive terms than conventional rock band practices have to offer. One direction in which this might lead is the expansion of the informal pedagogy based on a "garage band" model to encompass various modes of digital artistry wherever this artistry…

  15. 压裂管柱中陶粒对滑套球座影响%Influence of Sand in Fracturing String on Sleeve Tee

    Institute of Scientific and Technical Information of China (English)

    刘景超; 刘超; 王晓

    2016-01-01

    目的:防止陶粒对滑套球座产生破坏。方法利用有限元软件 LS-DYNA 对陶粒冲击滑套球座进行建模,分别改变陶粒与滑套球座表面涂层之间的摩擦系数、滑套球座涂层的厚度、陶粒的粒径、陶粒的速度和陶粒速度相对于滑套球座表面的角度,通过仿真结果观察参数变化对滑套球座表面应力的影响。结果随着陶粒和球座之间的静摩擦系数由0.1增加到0.4,球座的最大表面应力由1.67 GPa增加到2.33 GPa。随着球座表面涂层厚度由3µm增大到6µm,球座的最大表面应力由2.05 GPa减小到0.89 GPa。随着陶粒粒径由50µm增加到80µm,球座的最大表面应力由1.67 GPa增加到3.63 GPa。随着陶粒速度由24 m/s增加到96 m/s,球座的最大表面应力由0.96 GPa增加到2.42 GPa。随着陶粒和球座表面之间的夹角由15°增加到60°,球座的最大表面应力由1.67 GPa增加到4.12 GPa。结论压裂液的性能会影响陶粒和球座之间的摩擦系数,进而影响球座的表面应力大小。球座的表面涂层厚度适当增大可以降低其表面的最大应力,压裂液中陶粒的直径越大,单个陶粒对球座造成的冲击应力越大。可以通过设计使滑套球座表面与中心线的夹角尽量小,以减小球座的最大表面应力。施工排量的增大会加剧球座的破坏。%ABSTRACT:Objective To prevent damage of sleeve tee caused by sand.Methods Using the finite element software LS-DYNA, the impact of sand on sleeve tee was modeled. By changing the coefficient of friction between the ball seat surface and sand, the thickness of the coating, the diameter of sand, the speed of sand, the angle between sand velocity and sleeve tee surface, the effects of parameter changes on sleeve tee surface stress were observed by simulation results.Results With the stat-ic coefficient of friction between the sand and the ball seat increasing from 0.1 to 0.4, the maximum surface

  16. Long Lake banding project, 1965

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the results of a banding project on Long Lake in 1965. The dates at the banding site were July 27th through August 8th. As in the past, the...

  17. 全胃切除术后的营养及代谢改变%Nutrition and metabolism changes after total gastrectomy

    Institute of Scientific and Technical Information of China (English)

    常文举; 牛伟新

    2008-01-01

    Obviously pathophysiologic changes will appear with patients undergoing total gastrectomy.The changes will influence the long-term prognosis and quality of life of the patient.Regulation of food intake,enterokinesia and metabolism of nutritions will alter after the operation.These will lead to many postoperative complications,such as early dumpling syndrome(EDS),reflux of esophagitis,dyspepsia and malabsorption of the nutrients.%全胃切除术后患者机体内的营养及代谢会发生明显改变,影响患者的长期预后和生活质量(QOL).全胃切除术后患者的摄食调节、肠动力、营养物的消化和吸收功能都发生了改变.常引起各种术后并发症,如早期倾倒综合征(EDS)、反流性食管炎、营养的消化吸收不良等.

  18. Application and long-term follow-up study of gastrectomy in children%小儿胃切除术的应用及远期随访

    Institute of Scientific and Technical Information of China (English)

    孙大昂; 孙晓毅; 余东海

    2012-01-01

    Objective To retrospectively summary the experiences for gastrectomy in infants.Methods Between December 2006 and 2011 January,totally 15 cases of infants (average age:39.9 ±23.2 m) underwent gastrectomy in our department and the review of their clinical data was conducted.Results All patients underwent surgery to effectively control bleeding or remove lesion,and no complications was found in this study.The follow-up was conducted in all patients,in which the follow-up time was more than 3 years in 10 cases and less than 3 years in 5 cases.Within one year follow up period,9 patients undertaking gastric lesion resection with less than 50% gastric body resection or Billroth Ⅰ gastroentestinal reconstruction showed normal hemoglobin and albumin level,as well weight up to normal one.Better diet and growth/development could be seen in them.The other 6 patients who undertaking more than 50% gastric body resection and Billroth Ⅱ anastomosis showed anemia and hypoproteinemia in 3 cases,less weight than normal one in 2 cases within 1 year of follow-up.1 patients undertaking subtotal gastrectomy due to huge stomach duplication showed a slight anemia within 3years of follo(w) up,and growth.development reached to normal level in 6 years.Conclusions Children undertaking gastric lesion resection with less than 50% gastric body resection or Billroth Ⅰ gastroentestinal reconstruction had low incidence of postoperative complications due to better stomach compensation,and no significant negative effects on children's growth and development can be seen in this study,but the subtotal gastrectomy or Billroth Ⅱ procedure,and long term of follow-up is still needed.%目的 总结小儿胃切除的经验.方法 回顾性分析2006年12月至2011年1月间行小儿胃切除术15例的临床及随访资料.结果 本组均手术成功,术后无并发症发生,痊愈出院.所有患儿均获随访;随访时间>3年10例;3年以内5例.9例行不规

  19. Influence of upper limb motion on the design of garment sleeve ease%人体上肢运动对服装袖型松量设计的影响分析

    Institute of Scientific and Technical Information of China (English)

    孙鑫磊

    2012-01-01

    为了解决服装袖型松量设计与人体上肢运动关系的问题,结合人体上肢的形态结构及几种常规运动,重点测量了7种人体上肢运动状态下的人体上肢各个部位的尺寸变化,结合衣袖结构设计的相关理论,对人体上肢尺寸变化情况的数据进行了分析,得出了与各种上肢运动状态对应的袖型松量设计的基本要求,进而分析了人体上肢运动对服装袖型松量设计的影响.%In order to investigate the relations of garment sleeve design of the pine and the movement of human upper limb, seven kinds of human upper extremity dimensions of all parts of the upper limbs of the human body in motion were measured based on mor- phology and several regular movements of the upper limbs of the human body. Then through the data analysis of human upper limb size changes and the combination of related theories on sleeve structure design, the basic requirement of the upper limb that corresponds to the design of sleeve-type were put forward, and the effect of human upper limb motion on the design of garment sleeve loose is analyzed.

  20. AWE-based Optimum Design of Sliding-sleeve of Gantry Type Machine%基于AWE的龙门式框架设备升降滑套优化设计

    Institute of Scientific and Technical Information of China (English)

    高文进; 张进生; 王志; 王发凯

    2011-01-01

    A finite element analysis was carried out on the familiar sliding-sleeve structure of the gantry type machine with the SolidWorks and ANSYS Workbench software. Through analyzing the changes of static and dynamic performances under different forms and arrangements of the ribs of sliding-sleeve, an optimal solution was obtained. Moreover, taking the thickness of steel plates as design variables, the weight, stress and deformation of the plates as the objective function, an optimal sliding - sleeve was obtained by using DOE method.%运用SolidWorks和ANSYSWorkbench,对常见的龙门框架设备升降滑套进行有限元分析.通过改变升降滑套筋板形式,观察升降滑套的静、动态特性变化,得出了筋板优化结构.在AWE优化环境中,应用DOE实验设计方法,以升降滑套板厚为设计变量,同时控制质量、受力、变形等多个目标因子,最终获得了综合指标趋向最好的升降滑套.

  1. Microstrip microwave band gap structures

    Indian Academy of Sciences (India)

    V Subramanian

    2008-04-01

    Microwave band gap structures exhibit certain stop band characteristics based on the periodicity, impedance contrast and effective refractive index contrast. These structures though formed in one-, two- and three-dimensional periodicity, are huge in size. In this paper, microstrip-based microwave band gap structures are formed by removing the substrate material in a periodic manner. This paper also demonstrates that these structures can serve as a non-destructive characterization tool for materials, a duplexor and frequency selective coupler. The paper presents both experimental results and theoretical simulation based on a commercially available finite element methodology for comparison.

  2. Rotational Bands in 172W

    Science.gov (United States)

    Greenberg, J.; Guess, C. J.; Tandel, S.; Chowdhury, P.; Carpenter, M. P.; Hartley, D. J.; Janssens, R. V. F.; Khoo, T. L.; Lauritsen, T.; Lister, C. J.; Seweryniak, D.; Shirwadkar, U.; Wang, X.; Zhu, S.

    2015-10-01

    Studying the structure of rotational bands in 172W is valuable for gaining a better understanding of deformed nuclei. Highly excited states of the isotope were populated from a 230 MeV 50Ti beam incident on a 128Te target at Argonne National Laboratory using the ATLAS accelerator. γ emissions from 172W in the range were measured using Compton suppressed germanium detectors in the Gammasphere array. Using this data, three new rotational bands were found, and several other bands were expanded. Swarthmore College Summer Research Fellowship.

  3. Some parallel banded system solvers

    Energy Technology Data Exchange (ETDEWEB)

    Dongarra, J.J.; Sameh, A.H.

    1984-12-01

    This paper describes algorithms for solving narrow banded systems and the Helmholtz difference equations that are suitable for multiprocessing systems. The organization of the algorithms highlight the large grain parallelism inherent in the problems. 13 references, 5 tables.

  4. CFG地基处理套筒钻施工工法浅析%On CFG Sleeve Drilling Construction Method of Foundation Treatment

    Institute of Scientific and Technical Information of China (English)

    赵显涛; 于淑艳

    2014-01-01

    CFG水泥粉煤灰碎石桩作为一种地基处理方法,在工程中得到越来越多的应用。桩和桩间土一起,通过褥垫层形成复合地基共同工作,可有效提高地基承载力。本文针对抚顺某工地 CFG 地基处理采用的套筒螺旋钻的施工工艺,浅析这种工艺在处理节理裂隙发育及断裂带岩体中的实际应用,为实际工程提供指导和参考。%CFG cement fly ash gravel pile as a foundation tre-atment method, obtained more and more applications in eng-ineering. Pile and soil between piles composite foundation for-med together, work together through the cushion, which can e-ffectively improve the bearing capacity of the foundation. Ai-ming at the construction site in Fushun CFG foundation treat-ment sleeve screw with dril construction process, analyze this process in the application in joint rock fracture and fracture treatment, to provide guidance and reference for practical engi-neering.

  5. 袖阀管注浆封闭截水施工技术%Construction Technology of Water Truncation with Sleeve Valve Pipe

    Institute of Scientific and Technical Information of China (English)

    霍小妹

    2011-01-01

    Water gushes occurred during the foundation excavation construction of underground garage service building of some residential building in Taiyuan. After comparing different grouting technologies, grouting with sleeve valve pipe is selected to solidify the ground. Mix proportion and grouting pressure of slurry are analyzed. Problems during construction are introduced in detail such as construction process, equipments selection, holes arrangement and forming, slurry making and grouting. Points for attention are discussed. By the reinforcement measures, the soil properties can reach construction requirements, and the water gushing is controlled.%针对太原市某住宅楼地下车库基坑工程在土方开挖中遇到涌水现象,经注浆技术比较,选用袖阀管注浆法对土体进行固化止水.分析砂土中所注浆液的配合比和注浆压力,对注浆施工流程、机械选用、钻孔布置及钻孔、浆液配制、下管和注浆施工等问题进行详细介绍,对注浆过程注意事项进行探讨.经加固的土体能满足施工要求.

  6. Narrow-Band Microwave Filters

    Directory of Open Access Journals (Sweden)

    A.V. Strizhachenko

    2010-01-01

    Full Text Available Original design of the narrow-band compact filters based on the high-quality waveguide-dielectric resonator with anisotropic materials has been presented in this work. Designed filters satisfy the contradictory requirements: they provide the narrow frequency band (0.05 ÷ 0.1 % of the main frequency f0 and the low initial losses α0 ≤ 1 dB.

  7. Analysis and Experimental Research on Erosion of Cementing Sliding Sleeve%套管固井滑套冲蚀磨损模拟分析与试验研究

    Institute of Scientific and Technical Information of China (English)

    魏辽; 韩峰; 陈涛; 郭朝辉; 朱玉杰

    2014-01-01

    为准确分析套管固井滑套长时间在固液两相流中冲蚀后的磨损情况及可靠性,在进行冲蚀理论分析和数值模拟的基础上,利用研制的冲蚀磨损试验装置,研究了特定工况下固井滑套带孔短节的冲蚀磨损情况,分析了滑套孔眼冲蚀磨损速率与孔眼数量、砂比及排量的关系,建立了冲蚀磨损速率新模型,研究了滑套带孔短节孔眼过流能力与冲蚀磨损速率的关系;同时,结合数值分析结果和试验数据,得到了A型材质滑套短节的冲蚀磨损系数。研究结果表明,当滑套孔眼为2个时,含砂流体对滑套孔眼周边的冲蚀磨损较为明显,且滑套孔眼冲蚀磨损速率与砂比呈线性关系,与排量呈指数关系。该研究结果可为套管固井滑套可靠性评估提供理论依据,且能够指导滑套压裂工具的现场应用。%In order to analyze the wear rate and reliability of cementing sliding sleeve after high dis-charge ,high sand-fluid ratio and long-term erosion of solid-liquid flow ,downhole tools’ erosion and wear were researched based on the erosion theory and numerical simulation .The effects of the number of ports , sand concentration and displacement on the wear rate were analyzed .New test equipment was designed and built to test the erosion wear of port collar of cementing sliding sleeve under certain working conditions .A new model of erosion rate was established and more research was conducted about the flow capacity of port collar of cementing sliding sleeve and its effect on the rate of erosion wear .By combining numerical analysis and test data ,the erosion coefficient of cementing sliding sleeve made by type A material was obtained .Re-sults showed that the hole erosion was more severe when the cementing sliding sleeve contains two holes . The erosion rate had a linear relationship with sand concentration and an exponential relationship with fluid displacement .T his research

  8. Comparison of laparoscopy-assisted and open radical gastrectomy for advanced gastric cancer: A retrospective study in a single minimally invasive surgery center.

    Science.gov (United States)

    Hao, Yingxue; Yu, Peiwu; Qian, Feng; Zhao, Yongliang; Shi, Yan; Tang, Bo; Zeng, Dongzhu; Zhang, Chao

    2016-06-01

    Laparoscopy-assisted gastrectomy (LAG) has gained international acceptance for the treatment of early gastric cancer (EGC). However, the use of laparoscopic surgery in the management of advanced gastric cancer (AGC) has not attained widespread acceptance. This retrospective large-scale patient study in a single center for minimally invasive surgery assessed the feasibility and safety of LAG for T2 and T3 stage AGC. A total of 628 patients underwent LAG and 579 patients underwent open gastrectomy (OG) from Jan 2004 to Dec 2011. All cases underwent radical lymph node (LN) dissection from D1 to D2+. This study compared short- and long-term results between the 2 groups after stratifying by pTNM stages, including the mean operation time, volume of blood loss, number of harvested LNs, average days of postoperative hospital stay, mean gastrointestinal function recovery time, intra- and post-operative complications, recurrence rate, recurrence site, and 5-year survival curve. Thirty-five patients (5.57%) converted to open procedures in the LAG group. There were no significant differences in retrieved LN number (30.4 ± 13.4 vs 28.1 ± 17.2, P = 0.43), proximal resection margin (PRM) (6.15 ± 1.63 vs 6.09 ± 1.91, P = 0.56), or distal resection margin (DRM) (5.46 ± 1.74 vs 5.40 ± 1.95, P = 0.57) between the LAG and OG groups, respectively. The mean volume of blood loss (154.5 ± 102.6 vs 311.2 ± 118.9 mL, P < 0.001), mean postoperative hospital stay (7.6 ± 2.5 vs 10.7 ± 3.6 days, P < 0.001), mean time for gastrointestinal function recovery (3.3 ± 1.4 vs 3.9 ± 1.5 days, P < 0.001), and postoperative complications rate (6.4% vs 10.5%, P = 0.01) were clearly lower in the LAG group compared to the OG group. However, the recurrence pattern and site were not different between the 2 groups, even they were stratified by the TNM stage. The 5-year overall survival (OS) rates were 85.38%, 79.70%, 57

  9. U and Pu Gamma-Ray Measurements of Spent Fuel Using a Gamma-Ray Mirror Band-Pass Filter

    Energy Technology Data Exchange (ETDEWEB)

    Ziock, Klaus-Peter [ORNL; Alameda, J.B. [Lawrence Livermore National Laboratory (LLNL); Brejnholt, N.F. [Lawrence Livermore National Laboratory (LLNL); Decker, T.A. [Lawrence Livermore National Laboratory (LLNL); Descalle, M.A. [Lawrence Livermore National Laboratory (LLNL); Fernandez-Perea, M. [Lawrence Livermore National Laboratory (LLNL); Hill, R.M. [Lawrence Livermore National Laboratory (LLNL); Kisner, R.A. [Oak Ridge National Laboratory (ORNL); Melin, A.M. [Oak Ridge National Laboratory (ORNL); Patton, B.W. [Lawrence Livermore National Laboratory (LLNL); Ruz, J. [Lawrence Livermore National Laboratory (LLNL); Soufli, R. [Lawrence Livermore National Laboratory (LLNL); Pivovaroff, M.J. [Lawrence Livermore National Laboratory (LLNL)

    2014-01-01

    Abstract. We report on the use of grazing incidence gamma-ray mirrors to serve as a narrow band-pass filter for advanced non-destructive analysis (NDA) of spent nuclear fuel. The purpose of the mirrors is to limit the radiation reaching a HPGe detector to narrow spectral bands around characteristic emission lines from fissile isotopes in the fuel. This overcomes the normal rate issues when performing gamma-ray NDA measurements. In a proof-of-concept experiment, a set of simple flat gamma-ray mirrors were used to directly observe the atomic florescence lines from U and Pu from spent fuel pins with the detector located in a shirt-sleeve environment. The mirrors, consisting of highly polished silicon substrates deposited with WC/SiC multilayer coatings, successfully deflected the lines of interest while the intense primary radiation beam from the fuel was blocked by a lead beam stop. The gamma-ray multilayer coatings that make the mirrors work at the gamma-ray energies used here (~ 100 keV) have been experimentally tested at energies as high as 645 keV, indicating that direct observation of nuclear emission lines from 239Pu should be possible with an appropriately designed optic and shielding configuration.

  10. 胃癌根治术后腹腔感染的病原学分析%Etiological analysis on postoperative intra-abdominal infection after radical gastrectomy

    Institute of Scientific and Technical Information of China (English)

    肖华; 左朝晖; 欧阳永忠; 汤明; 唐卫; 潘曙光; 尹彬; 罗威; 权虎; 邱晓昕

    2013-01-01

    目的:对胃癌患者行根治性切除术后腹腔感染的病原学特征进行回顾性分析。方法回顾性分析479例胃癌患者根治术后腹腔感染的病原学种类及药敏结果。结果479例患者中32例术后出现腹腔感染(6.68%),病原学阳性者27例,阳性率为84.38%。检出病原菌32株,其中革兰阴性菌24株(75.00%),包括大肠埃希菌15株(46.86%),肺炎克雷伯菌3株(9.38%),普通变形杆菌、奇异变形杆菌、阴沟肠杆菌、普城沙雷菌、不动杆菌及铜绿假单胞菌各1株(各占3.13%);革兰阳性菌7株(21.88%),包括粪肠球菌4株(12.50%),耐久肠球菌、金黄色葡萄球菌及溶血性葡萄球菌各1株(3.13%);真菌1株(3.13%)。药敏结果显示32株病原菌中,对常用抗菌药物的耐药率较高,其中革兰阴性菌对美洛培南敏感性最高(91.67%),而革兰阳性菌对万古霉素最为敏感(85.71%)。结论大肠埃希菌、粪肠球菌、肺炎克雷伯菌是胃癌患者根治术后腹腔感染最主要的致病菌,临床上应注意合理使用抗菌药物。%Objective To analyze the epidemiology characteristics of bacteria in postoperative intra-abdominal infection after radical gastrectomy, retrospectively. Methods Data of 479 patients undergoing radical gastrectomy were collected. The species of the pathogens responsible for postoperative intra-abdominal infection and the result of drug susceptibility were analyzed, retrospectively. Results There were 32 (6.68%) among the 479 patients were suffered from postoperative intra-abdominal infection, in which 27 (84.38%) patients had positive pathogen detection. Total of 32 bacilli lines were separated, of which 24 (75.00%) strains were Gram-negative bacilli, including 15 (46.86%) strains of Escherichia coli, 3 (9.38%) strains of Klebsiellap pneumonia and one strains of Proteus vulgaris, Proteus mirabilis, Enterobacter cloacae, Princeton marcescens

  11. Direct band gap silicon allotropes.

    Science.gov (United States)

    Wang, Qianqian; Xu, Bo; Sun, Jian; Liu, Hanyu; Zhao, Zhisheng; Yu, Dongli; Fan, Changzeng; He, Julong

    2014-07-16

    Elemental silicon has a large impact on the economy of the modern world and is of fundamental importance in the technological field, particularly in solar cell industry. The great demand of society for new clean energy and the shortcomings of the current silicon solar cells are calling for new materials that can make full use of the solar power. In this paper, six metastable allotropes of silicon with direct or quasidirect band gaps of 0.39-1.25 eV are predicted by ab initio calculations at ambient pressure. Five of them possess band gaps within the optimal range for high converting efficiency from solar energy to electric power and also have better optical properties than the Si-I phase. These Si structures with different band gaps could be applied to multiple p-n junction photovoltaic modules. PMID:24971657

  12. X-Band PLL Synthesizer

    Directory of Open Access Journals (Sweden)

    P. Kutin

    2006-04-01

    Full Text Available This paper deals with design and realization of a PLL synthesizer for the microwave X−band. The synthesizer is intended for use as a local oscillator in a K−band downconverter. The design goal was to achieve very low phase noise and spurious free signal with a sufficient power level. For that purpose a low phase noise MMIC VCO was used in phase locked loop. The PLL works at half the output frequency, therefore there is a frequency doubler at the output of the PLL. The output signal from the frequency doubler is filtered by a band-pass filter and finally amplified by a single stage amplifier.

  13. Shear Banding of Complex Fluids

    Science.gov (United States)

    Divoux, Thibaut; Fardin, Marc A.; Manneville, Sebastien; Lerouge, Sandra

    2016-01-01

    Even in simple geometries, many complex fluids display nontrivial flow fields, with regions where shear is concentrated. The possibility for such shear banding has been known for several decades, but in recent years, we have seen an upsurge in studies offering an ever-more precise understanding of the phenomenon. The development of new techniques to probe the flow on multiple scales with increasing spatial and temporal resolution has opened the possibility for a synthesis of the many phenomena that could only have been thought of separately before. In this review, we bring together recent research on shear banding in polymeric and soft glassy materials and highlight their similarities and disparities.

  14. Holographic Multi-Band Superconductor

    CERN Document Server

    Huang, Ching-Yu; Maity, Debaprasad

    2011-01-01

    We propose a gravity dual for the holographic superconductor with multi-band carriers. Moreover, the currents of these carriers are unified under a global non-Abelian symmetry, which is dual to the bulk non-Abelian gauge symmetry. We study the phase diagram of our model, and find it qualitatively agrees with the one for the realistic 2-band superconductor, such as MgB2. We also evaluate the holographic conductivities and find the expected mean-field like behaviors in some cases. However, for a wide range of the parameter space, we also find the non-mean-field like behavior with negative conductivities.

  15. Technical Analysis and Performance Evaluation of Sliding Sleeve Seal%滑套密封技术分析与性能评估∗

    Institute of Scientific and Technical Information of China (English)

    余海燕; 雷中清; 冯强; 党伟; 周俊然; 王益山

    2015-01-01

    As an important tool of the slicing mining technology of petroleum and natural gas,sliding sleeves’ sealing performance directly affects on the slicing mining effect.Different sealing solutions used for the sliding sleeves were classi⁃fied and summarized,including the O⁃ring seal,lip seal,special seal and their different combination sealing forms.The seal⁃ing performances were evaluated for different forms of seals from five aspects,such as sealing effect,shearing resistance, wear resistance,service life and cost.By considering the five indicators synthetically,sleeve seals can choose simple star⁃rings,star⁃rings with apron,U⁃rings,double triangle rings of Tecom,and other forms of seals.Taking economy and practica⁃bility into consideration,simple O⁃rings and O⁃rings with flat apron are more applicable at slow speed and low pressure, and combination of O⁃rings and trapezoidal rings,fabric reinforced rubber combination V⁃ring seals,K⁃type seals of Tecom Manchester,T⁃rings of TeKanggelai are usually used at high pressure and large speed change.%滑套作为石油天然气分层开采技术的重要工具,其密封性能直接影响着施工的效果。对用于滑套的不同密封方案进行总结分类,包括O形圈密封、唇形密封、特殊型密封及其不同的组合密封形式;从密封效果、抗剪切性、耐磨性、使用寿命、成本5项指标对各类密封进行性能评估。综合考虑5项指标,滑套密封可选用简单星形密封圈、星形密封圈加挡圈、 U型密封圈、特康双三角密封圈等密封形式;而从经济实用方面来考虑,低压且速度不高时,可使用简单O形圈、 O形密封圈加平挡圈;压力较高且速度变化较大时,可使用O形圈和梯形环的组合、 V形夹织物橡胶组合密封圈、 K型特康斯特密封圈、 T型特康格来圈。

  16. Gastric band migration following laparoscopic adjustable gastric banding (LAGB): two cases of endoscopic management using a gastric band cutter.

    Science.gov (United States)

    Rogalski, Pawel; Hady, Hady Razak; Baniukiewicz, Andrzej; Dąbrowski, Andrzej; Kaminski, Fabian; Dadan, Jacek

    2012-06-01

    Laparoscopic adjustable gastric banding (LAGB) is one of the most frequently used minimally invasive and reversible procedures for the treatment of morbid obesity. Migration of the gastric band into the gastric lumen is a rare late complication of LAGB. Previous attempts at endoscopic removal of migrated bands have included the use of endoscopic scissors, laser ablation and argon plasma coagulation (APC). We report two cases of successful endoscopic management of gastric band migration using a gastric band cutter. PMID:23256012

  17. Laparoscopic-assisted versus open distal gastrectomy with D2 lymph node resection for advanced gastric cancer: effect of learning curve on short-term outcomes. a meta-analysis.

    Science.gov (United States)

    Zhou, Di; Quan, Zhiwei; Wang, Jiandong; Zhao, Mingning; Yang, Yong

    2014-03-01

    Laparoscopic-assisted distal gastrectomy (LADG) with D2 resection is gradually being performed for treating advanced gastric cancer. This meta-analysis aims to compare the clinical outcomes between LADG and open distal gastrectomy (ODG) when considering the impact of the learning curve. The PubMed, Embase, and ISI databases and the Cochrane Library were electronically searched. Randomized controlled trails and retrospective comparative studies published between 1994 and 2013 were collected. We divided the included studies into two subgroups according to whether the authors had experience of at least or fewer than 40 cases of LADG with D2 resection and then compared the operative time, intraoperative bleeding, the amount of resected lymph nodes, short-term recovery parameters, and complications between LADG and ODG groups. Ten comparative studies including 1100 patients were selected. Meta-analysis showed that when LADG was compared with ODG, surgeons with experience of at least 40 cases could achieve more resected lymph nodes (P=.002), reduced time to flatus (Pdiet (P<.00001), and lower complication rates (P=.02). However, the above advantages of LADG faded in the subgroup of surgeons with experience of fewer than 40 cases. Our meta-analysis suggested that the learning curve has significant effects on most of the important surgical and short-term recovery outcome parameters. Accomplishment of 40 cases of LADG with D2 lymphadenectomy is required to achieve optimum proficiency.

  18. Bands for girls and boys

    Institute of Scientific and Technical Information of China (English)

    王为成

    2001-01-01

    Like many people, you may be dreaming of a career(职业) as rock and roll stars. There are two ways to go about getting one. First is the traditional way. Find some friends and form a group. Learn to play the guitar or the drums. Write your own songs. Spend hours arguing about the band name. Then go out on the road.

  19. Tolerance bands for functional data.

    Science.gov (United States)

    Rathnayake, Lasitha N; Choudhary, Pankaj K

    2016-06-01

    Often the object of inference in biomedical applications is a range that brackets a given fraction of individual observations in a population. A classical estimate of this range for univariate measurements is a "tolerance interval." This article develops its natural extension for functional measurements, a "tolerance band," and proposes a methodology for constructing its pointwise and simultaneous versions that incorporates both sparse and dense functional data. Assuming that the measurements are observed with noise, the methodology uses functional principal component analysis in a mixed model framework to represent the measurements and employs bootstrapping to approximate the tolerance factors needed for the bands. The proposed bands also account for uncertainty in the principal components decomposition. Simulations show that the methodology has, generally, acceptable performance unless the data are quite sparse and unbalanced, in which case the bands may be somewhat liberal. The methodology is illustrated using two real datasets, a sparse dataset involving CD4 cell counts and a dense dataset involving core body temperatures. PMID:26574904

  20. A PHOTONIC BAND GAP FIBRE

    DEFF Research Database (Denmark)

    1999-01-01

    An optical fibre having a periodicidal cladding structure provididing a photonic band gap structure with superior qualities. The periodical structure being one wherein high index areas are defined and wherein these are separated using a number of methods. One such method is the introduction...

  1. Metaphyseal bands in osteogenesis imperfecta

    International Nuclear Information System (INIS)

    An increasing number of patients with osteogenesis imperfecta are undergoing pamidronate therapy to prevent the incidence of fragility fractures. The authors herein report a child aged 3 years who received five cycles of pamidronate, resulting in metaphyseal bands, known as “zebra lines.”

  2. Linear methods in band theory

    DEFF Research Database (Denmark)

    Andersen, O. Krogh

    1975-01-01

    Two approximate methods for solving the band-structure problem in an efficient and physically transparent way are presented and discussed in detail. The variational principle for the one-electron Hamiltonian is used in both schemes, and the trial functions are linear combinations of energy-indepe...

  3. Familial band-shaped keratopathy.

    Science.gov (United States)

    Ticho, U; Lahav, M; Ivry, M

    1979-01-01

    A brother and sister out of a consanguinous family of four siblings are presented as prototypes of primary band-shaped keratopathy. The disease manifested sever progressive changes of secondary nature over two years of follow-up. Histology and treatment are described.

  4. Ingestion of polydextrose increase the iron absorption in rats submitted to partial gastrectomy A ingestão de polidextrose aumenta a absorção de ferro em ratos submetidos à gastrectomia parcial

    Directory of Open Access Journals (Sweden)

    Elisvânia Freitas dos Santos

    2010-12-01

    Full Text Available PURPOSE: To investigate whether polydextrose stimulates iron absorption in rats submitted to partial gastrectomy and sham operated. METHODS: The rats were submitted to partial gastrectomy (Billroth II or laparotomy (sham-operated control, in groups of 20 and 20 each respectively. The animals were fed with a control diet (AIN-93M without polydextrose or a diet containing polydextrose (50g/Kg of diet for eight weeks. They were divided into four subgroups: sham-operated and Billroth II gastrectomy and with or without polydextrose. Two animals died during the experiment. All rats submitted to gastrectomy received B-12 vitamin (intramuscular each two weeks. The hematocrit and hemoglobin concentration were measured at the start and on day 30 and 56 after the beginning of the experimental period. At the end of the study, the blood was collected for determination of serum iron concentration. RESULTS: The diet with polydextrose reduced the excretion of iron. Apparent iron absorption was higher in the polydextrose fed groups than in the control group. The haematocrit and haemoglobin concentration were lower after Billroth II gastrectomy rats fed the control diet as compared to the polydextrose diet groups. CONCLUSION: Polydextrose increase iron absorption and prevents postgastrectomy anemia.OBJETIVO: Investigar se a polidextrose estimula a absorção de ferro em ratos submetidos à gastrectomia parcial e sham operados. MÉTODOS: Os ratos foram submetidos à gastrectomia parcial (Billroth II e à laparotomia (controle sham-operados em grupos de 20 e 20 cada, respectivamente. Os animais foram alimentados com uma dieta controle (AIN-93M, sem polidextrose ou uma dieta contendo polidextrose (50g/kg de dieta durante oito semanas. Foram divididos em quatro grupos: sham-operados e com gastrectomia BII e com ou sem polidextrose. Dois animais morreram durante o experimento. Todos os ratos com gastrectomia receberam vitamina B-12 (intramuscular a cada duas semanas

  5. Application of Reaming Honing Technology in Valve Sleeve of Automobile Steering Gear%铰珩工艺在汽车转向器阀套中的应用研究

    Institute of Scientific and Technical Information of China (English)

    刘晓石

    2012-01-01

    A single - pass honing technology with super hard abrasive, named reaming honing technology, is used to solve the Sow accuracy and efficiency caused by the traditional honing technology which is used to machine the valve sleeve of automobile steering gear. The fixture and cutter proposal is given according to the machining characters of the valve sleeve, and the orthogonal test is used to investigate the effects of the reaming honing parameters on the machining performance. The reaming honing technology with the optimized parameters proves itself to solve the accuracy problem in the machining of valve sleeve effectively, as a result the match grinding processing is cancelled and the machining efficiency is improved.%针对传统珩磨工艺在汽车转向器阀套加工中存在的精度不足和效率不高问题,引入一种单冲程超硬磨料珩磨孔加工技术,即铰珩工艺.根据阀套的加工特点,设计相应的夹具和刀具方案,并通过正交试验法研究铰珩工艺参数对加工性能的影响.参数经过优化的铰珩工艺,有效解决了阀套内孔加工的精度问题,取消了配磨工序,提高了加工效率.

  6. 含肾上腺素的肿胀麻醉技术在袖套式包皮环切术中的应用%Application of tumescent anesthesia with adrenaline for sleeve circumcision

    Institute of Scientific and Technical Information of China (English)

    施问国; 牟北平; 郑玉林; 李罡; 高炎

    2011-01-01

    目的:探讨含肾上腺素的肿胀麻醉技术在袖套式包皮环切术中的安全性和有效性.方法:应用含肾上腺素30μg、利多卡因60mg共6ml肿胀液行肿胀麻醉,对170例受术者实施袖套式包皮环切术.结果:所有受术者麻醉满意,麻醉维持4~7h.术中皮下小动脉、小静脉痉挛,切断的小血管断端无流血,术后无反应性出血,皮肤无坏死,切口一期愈合.结论:袖套式包皮环切术时含肾上腺素30μg的肿胀麻醉方法是一种安全,简单和有效的麻醉方法.%Objective To explore the safety and efficacy of tumescent anesthesia with adrenaline for sleeve circumcision. Methods 170 cases of sleeve circumcision were performed under 6ml of tumescent anesthesia solution containing adrenaline 30μg and lidocaine 60mg. Results Satisfactory anesthesia results were obtained in all cases.Intraoperative subcutaneous arterioles and venules are in spasm and cut without bloodshed. Incisions were all healed in one stage with no infection, no delayed haemorrage and no adrenaline-induced skin necrosis. Conclusions The tumescent anesthesia with adrenaline 30μg is safe, simple and effective for sleeve circumcision.

  7. Clincal observation on the treatment of redundant prepuce by sleeve circumcision%套袖式包皮环切术治疗包皮过长的临床观察

    Institute of Scientific and Technical Information of China (English)

    韦炳朝

    2012-01-01

      目的观察套袖式包皮环切术治疗包皮过长的临床疗效.方法80例包皮过长患者行套袖式包皮环切术,观察患者早期术后并发症、术后3个月性生活状况及手术满意度情况.结果80例患者术后3 d 出现包皮轻度水肿占31.3%,术后轻度疼痛占20%,术后3个月随访患者性功能均无减退,对手术满意者占95%.结论套袖式包皮环切术术后并发症少,不影响术后性功能,患者满意度高.%  Objective To observe the clinical effect of treament for patients of redundant prepuce by sleeve circumcision. Methods Study 80 cases of redundant prepuce by sleeve circumcision on the postoperative complication in the early time after operation, the status of sexual life and satisfaction of the patient 3 months after operation. Results 80 cases had foreskin mild edema in 31.3%, mild pain in 20% three days after surgery .All the patients had no decline in sexual life ,and accounted for 95% of surgical satisfaction after three months follow-up. Conclusion Sleeve circumcision has fewer postoperative complications, no affect sexual function and higher patient satisfaction .

  8. Index finger radial digital proper artery transfer and sleeve anastomosis to treat thumb digital artery defect%食指桡侧指固有动脉转位套入法治疗拇指断指

    Institute of Scientific and Technical Information of China (English)

    姚阳; 李崇杰

    2014-01-01

    Objective To investigate the effect of index finger radial digital proper artery transfer and sleeve anastomosis on treatment of thumb digital artery defect. Methods 10 cases of complete or incomplete thumb amputation with digital artery defect, but without tendon or nerve defect, were replanted by index finger radial digital proper artery transfer and sleeve anastomosis to thumb ulnar digital proper artery. Results All of 10 cases survived after operation, finger pulp was plump, color and lustre was florid. The patients were followed up for 10 months to 2 years, the hand function has obtained satisfactory recovery, and extrinsic feature was natural. Conclusion Index finger radial digital proper artery transfer and sleeve anastomosis is especially adaptive to the treatment of thumb digital artery defect.%目的:探讨食指桡侧指固有动脉转位套入法治疗拇指断指的疗效。方法对10例指动脉缺损而无肌腱神经缺损的拇指完全或不完全离断病例,采用食指桡侧指固有动脉转位与拇指尺侧指固有动脉行套入吻合法修复动脉,再植拇指。结果本组10例再植拇指均成活,指腹饱满,色泽红润,经6~24个月随访,患者手部功能恢复满意,外观自然,2例出现虎口狭窄,经手术改善。结论食指桡侧指固有动脉转位套入法适用于单纯拇指指动脉缺损的再植治疗。

  9. ALMA Band 5 Cartridge Performance

    Science.gov (United States)

    Billade, Bhushan; Lapkin, I.; Nystrom, O.; Sundin, E.; Fredrixon, M.; Finger, R.; Rashid, H.; Desmaris, V.; Meledin, D.; Pavolotsky, A.; Belitsky, Victor

    2010-03-01

    Work presented here concerns the design and performance of the ALMA Band 5 cold cartridge, one of the 10 frequency channels of ALMA project, a radio interferometer under construction at Atacama Desert in Chile. The Band 5 cartridge is a dual polarization receiver with the polarization separation performed by orthomode transducer (OMT). For each polarization, Band 5 receiver employs sideband rejection (2SB) scheme based on quadrature layout, with SIS mixers covering 163-211 GHz with 4-8 GHz IF. The LO injection circuitry is integrated with mixer chip and is implemented on the same substrate, resulting in a compact 2SB assembly. Amongst the other ALMA bands, the ALMA Band 5 being the lowest frequency band that uses all cold optics, has the largest mirror. Consequently, ALMA Band 5 mirror along with its support structure leaves very little room for placing OMT, mixers and IF subsystems. The constraints put by the size of cold optics and limited cartridge space, required of us to revise the original 2SB design and adopt a design where all the components like OMT, mixer, IF hybrid, isolators and IF amplifier are directly connected to each other without using any co-ax cables in-between. The IF subsystem uses the space between 4 K and 15 K stage of the cartridge and is thermally connected to 4 K stage. Avoiding co-ax cabling required use of custom designed IF hybrid, furthermore, due to limited cooling capacity at 4 K stage, resistive bias circuitry for the mixers is moved to 15 K stage and the IF hybrid along with an integrated bias-T is implemented using superconducting micro-strip lines. The E-probes for both LO and RF waveguide-to-microstrip transitions are placed perpendicular to the wave direction (back-piece configuration). The RF choke at the end of the probes provides a virtual ground for the RF/LO signal, and the choke is DC grounded to the chassis. The on-chip LO injection is done using a microstrip line directional coupler with slot-line branches in the

  10. Shear Banding of Complex Fluids

    OpenAIRE

    Divoux, Thibaut; Fardin, Marc-Antoine; Manneville, Sebastien; Lerouge, Sandra

    2015-01-01

    Even in simple geometries many complex fluids display non-trivial flow fields, with regions where shear is concentrated. The possibility for such shear banding has been known since several decades, but the recent years have seen an upsurge of studies offering an ever more precise understanding of the phenomenon. The development of new techniques to probe the flow on multiple scales and with increasing spatial and temporal resolution has opened the possibility for a synthesis of the many pheno...

  11. Band-selective radiofrequency pulses

    Science.gov (United States)

    Geen, Helen; Freeman, Ray

    A theoretical treatment is given of the general problem of designing amplitude-modulated radiofrequency pulses that will excite a specified band of frequencies within a high-resolution NMR spectrum with uniform intensity and phase but with negligible excitation elsewhere. First a trial pulse envelope is defined in terms of a finite Fourier series and its frequency-domain profile calculated through the Bloch equations. The result is compared with the desired target profile to give a multidimensional error surface. The method of simulated annealing is then used to find the global minimum on this surface and the result refined by standard gradient-descent optimization. In this manner, a family of new shaped radio-frequency pulses, known as BURP ( band-selective, uniform response, pure-phase) pulses, has been created. These are of two classes—pulses that excite or invert z magnetization and those that act as general-rotation πr/2 or π pulses irrespective of the initial condition of the nuclear magnetization. It was found convenient to design the latter class as amplitude-modulated time-symmetric pulses. Tables of Fourier coefficients and pulse-shape ordinates are given for practical implementation of BURP pulses, together with the calculated frequency-domain responses and experimental verifications. Examples of the application of band-selective pulses in conventional and multidimensional spectroscopy are given. Pure-phase pulses of this type should also find applications in magnetic resonance imaging where refocusing schemes are undesirable.

  12. S-Band propagation measurements

    Science.gov (United States)

    Briskman, Robert D.

    1994-08-01

    A geosynchronous satellite system capable of providing many channels of digital audio radio service (DARS) to mobile platforms within the contiguous United States using S-band radio frequencies is being implemented. The system is designed uniquely to mitigate both multipath fading and outages from physical blockage in the transmission path by use of satellite spatial diversity in combination with radio frequency and time diversity. The system also employs a satellite orbital geometry wherein all mobile platforms in the contiguous United States have elevation angles greater than 20 deg to both of the diversity satellites. Since implementation of the satellite system will require three years, an emulation has been performed using terrestrial facilities in order to allow evaluation of DARS capabilities in advance of satellite system operations. The major objective of the emulation was to prove the feasibility of broadcasting from satellites 30 channels of CD quality programming using S-band frequencies to an automobile equipped with a small disk antenna and to obtain quantitative performance data on S-band propagation in a satellite spatial diversity system.

  13. An extension to flat band ferromagnetism

    Science.gov (United States)

    Gulacsi, M.; Kovacs, G.; Gulacsi, Z.

    2014-11-01

    From flat band ferromagnetism, we learned that the lowest energy half-filled flat band gives always ferromagnetism if the localized Wannier states on the flat band satisfy the connectivity condition. If the connectivity conditions are not satisfied, ferromagnetism does not appear. We show that this is not always the case namely, we show that ferromagnetism due to flat bands can appear even if the connectivity condition does not hold due to a peculiar behavior of the band situated just above the flat band.

  14. 手助腹腔镜胃癌 D2根治术的团队配合%Teamwork Cooperation in Hand-assisted Laparoscopic D2 Radical Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    周均; 曹永宽; 宋亚宁; 王永华; 张国虎; 王培红; 李旭

    2014-01-01

    目的:探讨手助腹腔镜胃癌D2根治术的团队配合技巧及重要性。方法对我中心2010年12月~2013年6月180例手助腹腔镜胃癌D2根治术的临床资料进行回顾性总结。术者及助手相对固定,只需术者及扶镜手两人相互配合,就能完成肿瘤的根治性切除及淋巴结清扫。结果180例均在手助腹腔镜下完成手术,全胃切除术84例,远端胃切除术81例,近端胃切除术15例。手术切口长度(6.9±0.5)cm;术中出血量(226.1±127.0)ml;手术时间(172.2±34.1)min;病检获淋巴结数(17.3±5.0)枚;术后住院时间(9.3±2.0) d。围手术期死亡1例,手术残端癌残留2例。手术相关并发症率6%(11/180)。术后随访1~24个月,失访12例(失访率7%),同时性肝转移4例,异时性淋巴结转移2例,局部复发1例,未发生切口和穿刺口种植。结论良好的团队配合是保证手助腹腔镜胃癌D2根治术的必备条件,对肿瘤的根治程度、手术时间及术后并发症的发生起着至关重要的作用。%Objective To discuss the importance of teamwork coorperation in hand-assisted laparoscopic D2 radical gastrectomy. Methods Clinical materials of 180 patients with gastric cancer undergoing hand-assisted laparoscopic D2 radical gastrectomy from December 2010 to June 2013 were summarized retrospectively.The lymph nodes dissection and radical tumor excision were performed by two persons of cooperation that the operator surgeon worked with camera assistant in a relatively fixed mode in the operation. Results The hand-assisted laparoscopic D2 radical gastrectomy was accomplished in all the patients.Among the 180 patients, gastrectomy was performed in 84 cases, distal gastrectomy in 81 cases, and proximal gastrectomy in 15 cases.The average length of incision was (6.9 ±0.5) cm, the blood loss was (226.1 ±127.0) ml, the operative time was (172.2 ±34.1) min, the number

  15. Fatores prognósticos nas gastrectomias com linfadenectomia D2 por adenocarcinoma gástrico Prognostic factors in D2 gastrectomy for gastric adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Osvaldo Antonio Prado Castro

    2009-09-01

    comprometimento tumoral na câmara gástrica, o estádio da doença, a ocorrência de metástases a distância e principalmente a presença de metástases linfonodais, constituíram-se em variáveis com valor prognóstico independente.BACKGROUND: Lymphatic spread is more common in gastric cancer than the hematogenic one. Thus, the locoregional dissection type D2 seems to be important. AIM: To evaluate the overall survival after D2 gastrectomy for gastric adenocarcinoma and to determine the most important prognostic factors, including those with independent statistical value. METHODS: Prospective study with 125 patients operated between August 1997 and October 2005. The technique employed followed strictly the protocol of the National Cancer Center - Tokyo. RESULTS: There were 73 men and 52 women with ages ranging 28 to 84 years (mean of 58.96 ± 14.01. Seventy per cent of the lesions were located at the distal portion of the stomach, 20% were proximal and 10% comprised the whole organ. The stage distributions were: I - 37 cases (29.6%, II - 20 cases (16%, III - 37 cases (29.6%, and IV - 31 cases (24.8%. It was performed the amount of 73 subtotal gastrectomies and 52 totals. The morbidity rate was 26.4%, mainly, due to leakage and pulmonary complications. The overall mortality rate was 9.6%. After a mean follow-up of 48 months, 68 (54.4% patients were dead, representing an overall survival rate of 45.6%. Univariate and multivariate statistical analysis revealed that: tumors comprising the whole stomach, beyond the serosal layer (T3 or T4, with more than seven metastatic lymph nodes (N2 or N3, with distant metastasis (M1, and belonging to the stage III or IV of the disease, were related to a poor prognosis. CONCLUSIONS: Less than a half of the patients were alive after a mean follow-up of almost four years; the TNM stage system was the main prognostic factor, ergo, the extension of the lesions, the stage of the disease, metastatic occurrence and mainly the lymph node involvement

  16. Gastric band migration following laparoscopic adjustable gastric banding (LAGB): two cases of endoscopic management using a gastric band cutter

    OpenAIRE

    Rogalski, Pawel; Hady, Hady Razak; Baniukiewicz, Andrzej; Dąbrowski, Andrzej; Kaminski, Fabian; Dadan, Jacek

    2011-01-01

    Laparoscopic adjustable gastric banding (LAGB) is one of the most frequently used minimally invasive and reversible procedures for the treatment of morbid obesity. Migration of the gastric band into the gastric lumen is a rare late complication of LAGB. Previous attempts at endoscopic removal of migrated bands have included the use of endoscopic scissors, laser ablation and argon plasma coagulation (APC). We report two cases of successful endoscopic management of gastric band migration using ...

  17. Design of smooth orthogonal wavelets with beautiful structure from 2-band to 4-band

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    A complete algorithm to design 4-band orthogonal wavelets with beautiful structure from 2-band orthogonal wavelets is presented. For more smoothness, the conception of transfer vanishing moment is introduced by transplanting the requirements of vanishing moment from the 4-band wavelets to the 2-band ones. Consequently, the design of 4-band orthogonal wavelets with P vanishing moments and beautiful structure from 2-band ones with P transfer vanishing moments is completed.

  18. 牙轮钻头轴承套装配应力有限元分析及试验%Finite Element Analysis of Assembly Stress and Application of Rock Bit Bearing Sleeve

    Institute of Scientific and Technical Information of China (English)

    何畏; 刘杰; 邓嵘; 汤海平; 徐彤

    2012-01-01

    应用弹性力学理论对新型牙轮钻头的轴承套过盈配合进行受力分析,指出该方法具有局限性.采用ANSYS有限元分析软件和接触问题的有限元法,对新型牙轮钻头轴承套的装配进行仿真研究,确定了装配过盈量的最佳值.通过试验验证了理论分析的正确性和结构改进的可行性.%Theoretically,the stress of bearing sleeve interference fit of new type rock bit by the e-lasticity mechanics theory was analyzed. Based on the ANSYS and finite element method of contact problem,make the Simulation Study of the new rock bit bearing sleeve assembly set. Thus determine assembly process parameters of the best value over interference magnitude. Through experimental verification,demonstrate the validity of the theoretical analysis and the constructa-bility of structure improvement.

  19. 过共晶铝硅合金缸体/缸套工作面加工技术及应用%Working face machining technique and application of hypereutectic silicon aluminium alloy engine cylinder/cylinder sleeve

    Institute of Scientific and Technical Information of China (English)

    孙廷富; 杨波; 翟景; 郭安振; 郭锋; 崔崇亮

    2013-01-01

    综述了低过共晶铝硅合金、中过共晶铝硅合金以及高过共晶铝硅合金缸体/缸套材料的研究及进展情况,详细叙述了缸体孔/缸套工作面激光合金化、激光刻蚀、珩磨加工、等离子体涂覆、化学腐蚀等加工技术,对存在的问题进行分析总结,并提出解决方法。%Research progress of low hypereutectic silicon,medium hypereutectic silicon or high hypereutectic silicon aluminium alloy cylinder/cylinder sleeve is summarized. The machining techniques for cylinder hole and working face of cylinder sleeve such as laser alloying,laser ablation,honing,plasma coating,chemical corrosion and so on are introduced in detail. The existing problems are analysed and the resolving methods are put forward.

  20. 基于正交实验的转向器阀套铰珩工艺优化的研究%Optimization of the reaming honing process of valve sleeve based on orthogonal test

    Institute of Scientific and Technical Information of China (English)

    杨筱蓉; 朱永伟; 齐翔; 徐正选

    2013-01-01

    Reaming honing process of valve sleeve are studied by orthogonal tests and theoretical analysis. Influence factors of honing quality are as follows: the roundness value are determined by spindle speed and feed speed; the surface roughness value are determined by diamond size; the honing straightness value are determined by position accuracy of machine spindle, re-positioning accuracy of bench and the positioning accuracy of clamp system. Finally, process parameters of reaming honing are optimized for the high quality machining of valve sleeve.%运用正交实验设计方法和理论分析对加工转向器阀套内孔的铰珩工艺进行了研究,确定了影响阀套内孔铰珩质量的因素.结果表明:主轴转速和进给速度是圆度的决定性因素;珩具金刚石粒度的大小决定了粗糙度大小;机床加工轴的位置精度、工作台重复定位精度和夹具系统的定位精度决定了铰珩直线度.最终优化了铰珩工艺参数,实现了阀套的高质量加工.

  1. 底板组装过盈配合铜套内孔收缩量分析%Calculate on Shrinkage of The Endoporus of Copper Sleeve in Tight Fit

    Institute of Scientific and Technical Information of China (English)

    王福杰; 龚晓彬; 廖宁宁

    2015-01-01

    This paper introduces the common assembly method of tight fit, explores into the inner diameter of the copper in-terference with outside diameter shrinkage, calculated from the theory into the copper sleeve hole contraction, identify in practice how to easily find the shrinkage approach. This contraction in mechanical elements design, which will reflect on the inner hole size tolerance of copper, after the copper sleeve is pressed into the body, actual dimensions meet the requirements of shaft and hole fitting accuracy, both scientific and economic sense.%文章介绍了过盈配合常见的装配方法,探讨了压入铜套外径过盈量与内径收缩量的关系,从理论上计算出压入铜套的内孔收缩量,同时找出在实际工作中如何简便地求出收缩量的办法。从而在机械零件设计时将此收缩量反映到铜套内孔尺寸公差上,使铜套压入机体后,实际尺寸符合轴与孔要求的动配合精度,既科学又经济合理。

  2. 健康教育干预在胃癌根治术后患者的应用效果观察%Application of Health Education Intervention effect observation in patients with gastric cancer after radical Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    张志华

    2015-01-01

    Objective:To discuss the effect of health education intervention in patients after radical gastrectomy.Method:100 patients with gastric cancer were compared after radical gastrectomy in our hospital in groups,the effect of the mental state and physical state of them going through strong health education intervention in phychological and dietary aspects were observed and the following changes were recorded.Result:The patient’s mental state and physical condition in the experimental group were significantly better than those of the control group,differences between two groups were statistically significant(P<0.05).Conclusion:The application of psychological and dietary health education intervention to the patients after radical gastrectomy for gastric cancer results in a healthy and optimistic state of mind,improves the nutritional state after operation,thereby promoting the quality of life.%目的:探讨健康教育干预在胃癌根治术后患者的应用效果。方法:对笔者所在医院收治的100例胃癌根治术后患者进行分组比较,观察加强心理与饮食方面健康教育干预后胃癌根治术后患者心理状态与身体状态的变化效果。结果:观察组患者的心理状态、身体状态均显著优于对照组,两组比较差异均有统计学意义(P<0.05)。结论:加强心理与饮食方面的健康教育干预能使胃癌根治术后患者处于积极、健康、乐观的心理状态,改善术后身体营养状态,从而提高其生活质量。

  3. Study on Roux-en-Y Stasis Syndrome after Cardia Cancer Total Gastrectomy%贲门癌根治性全胃切除术后 Roux-en-Y 滞留综合征的研究

    Institute of Scientific and Technical Information of China (English)

    张水龙; 侯霞; 毕小刚; 张燕忠

    2014-01-01

    Objective To analyze the occurrence and prevention of Roux-en-Y stasis syndrome after cardiac carcinoma total gastrectomy .Methods The clinical data of 57 cases of total gastrectomy of cardiac cancer patients with Roux-en-Y stasis syndrome were retrospectively analyzed .Results In 57 patients,51 cases were followed up .There were 8 cases of obvious gastro-intestinal symptoms:2 cases of nausea ,vomiting only;3 cases of abdominal pain ,abdominal distension ,symptoms increased after eating;3 cases of abdominal pain ,abdominal distension accompanied by nausea ,vomiting.7 cases were confirmed as Roux-en-Y stasis syndrome,1 cases of tumor recurrence .Incidence rate of Roux-en-Y stasis syndrome was 13.7%(7/51).All the 7 patients were treated conservatively .Conclusion Roux-en-Y stasis syndrome was associated with Roux intestinal loop length and total gastrectomy.Early postoperative enteral nutrition and low dose of erythromycin can prevent its occurrence .%目的:分析贲门癌全胃切除术后Roux-en-Y滞留综合征发生的原因及其防治。方法回顾性分析57例贲门癌根治性全胃切除术后发生Roux-en-Y滞留综合征患者的临床资料。结果57例患者中51例获得随访,其中8例出现明显的胃肠道症状:2例出现单纯的恶心、呕吐;3例出现腹痛、腹胀,进食后症状加重;3例出现腹痛、腹胀同时伴恶心、呕吐。7例证实为Roux-en-Y滞留综合征,1例为肿瘤复发。术后Roux-en-Y滞留综合征发病率为13.7%(7/51),7例患者均行保守治疗。结论 Roux-en-Y滞留综合征的发生与Roux肠袢的长度及是否全胃切除有关,术后早期应用肠内营养剂及低剂量红霉素可预防其发生。

  4. 全胃切除术后两种Roux-en-Y消化道重建方式疗效比较%Comparing two kinds of Roux-en-Y digestive tract reconstruction after the whole gastrectomy

    Institute of Scientific and Technical Information of China (English)

    郭志民; 郭鑫

    2015-01-01

    目的::探讨全胃切除术后单纯Roux-en-Y吻合和P式Roux-en-Y吻合两种消化道重建方式的临床效果。方法:回顾性分析2012年1月至2014年12月期间我院48例胃癌患者全胃切除术后分别行单纯Roux-en-Y吻合(24例)和P式Roux-en-Y吻合法(24例)两种消化道重建方式患者临床资料,比较患者术后Roux潴留综合症( RSS)、碱性返流性食管炎、营养状况指标的差异。结果: P式Roux-en-Y吻合组和单纯Roux-en-Y吻合组在患者碱性返流性食管炎发生率无统计学差异(P>0.05),但P式Roux-en-Y吻合组患者术后的Roux潴留综合征(RSS)发生率、术后3个月及12个月患者营养指标营养状况指标较单纯Roux-en-Y吻合组好(P0. 05),but the rates of P-type Roux-en-Y retention in post-operative patients with Roux-Y stasis syndrome after gastrectomy ( RSS) and the patients’ nutritional indicator after three months and even twelve months as well as nutrition indicators Roux Group were performed very well (P<0. 05). Conclusion:Compared to simple Roux-en-Y anastomosis after total gastrectomy,P-Roux-en-Y pouch gastric anastomosis has good effect and can improve patients’ quali-ty of life,so it is an ideal digestive tract procedure after total gastrectomy.

  5. Rotational Bands in 11B

    Science.gov (United States)

    Demyanova, A. S.; Danilov, A. N.; Dmitriev, S. V.; Ogloblin, A. A.; Belyaeva, T. L.; Goncharov, S. A.; Gurov, Yu. B.; Maslov, V. A.; Sobolev, Yu. G.; Trzaska, W.; Heikkinen, P.; Julin, R.; Khlebnikov, S. V.; Tyurin, G. P.; Burtebaev, N.; Zholdybayev, T.

    2015-06-01

    Differential cross-sections of the 11B + α inelastic scattering at E(α) = 65 leading to the most of the known 11B states at the excitation energies up to 14 MeV were measured. The data analysis was done by DWBA and in some cases by the modified diffraction model allowing determining the radii of the excited states. The radii of the states with excitation energies less than ~ 7 MeV with the accuracy not less than 0.1-0.15 fm coincide with the radius of the ground state. This result is consistent with the traditional view of the shell structure of the low-lying states in 11B. Most of the observed high-energy excited states are distributed among four rotational bands. The moments of inertia of band states are close to the moment of inertia of the Hoyle state of 12C. The calculated radii, related to these bands, are 0.7 - 1.0 fm larger than the radius of the ground state, and are close to the radius of the Hoyle state. These results are in agreement with existing predictions about various cluster structure of 11B at high excitation energies. The state with the excitation energy 12.56 MeV, Iπ = 1/2+, T = 1/2 and the root mean square radius R ~ 6 fm predicted in the frame of the alpha condensate hypothesis was not found. The observed level at 12.6 MeV really has T = 1/2, probably, Iπ = 3/2+ and the radius close to that of the ground state.

  6. Bonds and bands in semiconductors

    CERN Document Server

    Phillips, Jim

    2009-01-01

    This classic work on the basic chemistry and solid state physics of semiconducting materials is now updated and improved with new chapters on crystalline and amorphous semiconductors. Written by two of the world's pioneering materials scientists in the development of semiconductors, this work offers in a single-volume an authoritative treatment for the learning and understanding of what makes perhaps the world's most important engineered materials actually work. Readers will find: --' The essential principles of chemical bonding, electron energy bands and their relationship to conductive and s

  7. Black Scholes’ model and Bollinger bands

    Science.gov (United States)

    Liu, Wei; Huang, Xudong; Zheng, Weian

    2006-11-01

    Bollinger bands are well-known in stock market as a popular technical analysis tool. We found that Black-Scholes stock price model had this Bollinger bands property also. In this paper, we give the proof of this phenomenon, and give a new distribution of a statistics generated by the Bollinger bands.

  8. High-energy band structure of gold

    DEFF Research Database (Denmark)

    Christensen, N. Egede

    1976-01-01

    The band structure of gold for energies far above the Fermi level has been calculated using the relativistic augmented-plane-wave method. The calculated f-band edge (Γ6-) lies 15.6 eV above the Fermi level is agreement with recent photoemission work. The band model is applied to interpret...

  9. DUAL-BAND INFRARED DETECTORS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    As the infrared technology continues to advance, there is a growing demand for multispectral detectors for advanced IR systems with better target discrimination and identification. Both HgCdTe detectors and quantum well GaAs/AlGaAs photodetectors offer wavelength flexibility from medium wavelength to very long wavelength and multicolor capability in these regions. The main challenges facing all multicolor devices are more complicated device structtures, thicker and multilayer material growth, and more difficult device fabrication, especially when the array size gets larger and pixel size gets smaller. In the paper recent progress in development of two-color HgCdTe photodiodes and quantum well infrared photodetectors is presented.More attention is devoted to HgCdTe detectors. The two-color detector arrays are based upon an n-P-N (the capital letters mean the materials with larger bandgap energy) HgCdTe triple layer heterojunction design. Vertically stacking the two p-n junctions permits incorporation of both detectros into a single pixel. Both sequential mode and simultaneous mode detectors are fabricated. The mode of detection is determined by the fabrication process of the multilayer materials.Also the performances of stacked multicolor QWIPs detectors are presented. For multicolor arrays, QWIP's narrow band spectrum is an advantage, resulting in low spectral crosstalk. The major challenge for QWIP is developing broadband or multicolor optical coupling structures that permit efficient absorption of all required spectral bands.

  10. 腹腔镜与开腹胃癌根治术的疗效及对患者免疫功能的影响%Laparoscopic versus open gastric radical gastrectomy: the efficacy and impact on immune function

    Institute of Scientific and Technical Information of China (English)

    夏亚斌; 郑成竹

    2013-01-01

    Objective:To compare the efficacies between laparoscopic and open radical gastrectomy and their impacts on immune function of patients.Methods:The clinical data of 114 gastric cancer patients admitted over the past 3 years were retrospectively analyzed.Of the patients,55 cases underwent laparoscopic gastrectomy (laparoscopy group) while 59 cases were subjected to open gastrectomy (laparotomy group).The postoperative immune function alterations,and intra-and postoperative conditions between the two groups of patients were compared.Results:The determination results for immune function parameters at 24 and 72 h after operation showed the levels of IL-2 and IL-6 in both groups were increased significantly compared with those before operation (all P<0.01),but the increasing degrees of both factors in laparotomy group were greater than those in laparoscopy group (all P<0.05); the peripheral blood levels of CD3+,CD4+,and CD8+ cells in laparotomy group were decreased significantly versus those before operation (all P<0.05),while no significant changes in above T cell subsets were noted in laparoscopy group (all P>0.05).Compared with laparotomy group,the intraoperative blood loss,frequency in analgesic use and postoperative complications in laparoscopy group were significantly reduced,and times to first flatus passage,liquid diet and ambulation as well as length of postoperative hospital stay were significantly shortened (all P<0.05).Conclusion:The efficacy of laparoscopic gastrectomy is better than that of open surgery,because it exerts less impact on immune function and with little systemic damage on the patients.%目的:比较腹腔镜与开腹胃癌根治术的疗效及对患者免疫功能的影响.方法:回顾性分析3年内收治的1 14例胃癌患者临床资料,其中55例行腹腔镜胃癌根治术(腹腔镜组)和59例行开腹胃癌根治术(开腹组),比较两组术后免疫功能的变化,以及术中、术后情况.结果:术后24,72 h免疫指

  11. 近端胃切除和远端胃切除术后远期并发症的对比观察%Proximal Gastric Resection and Long-term Complications after Distal Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    董昶三

    2015-01-01

    Objective To observe and compare the proximal gastric resection and long-term complications after distal gastrectomy.Methods 30 patients were randomly selected in 2013 January -2015 year in January in our hospital for proximal gastrectomypatients as the observation group A, 30 cases were randomly selected at the same timein our hospital for a distal gastrectomy patients as the observation group B.Results There were no obvious differences in incidence compared two groups of anastomotic inflammation, anastomotic ulcer complications (P > 0.05); observation group A weight loss, malnutrition and the incidence of reflux esophagitis and other complications was significantly higher than that in observation group B, the incidence was observed in the B group of bile reflux gastritis was significantly higher than that observed in A group, two groups of data by statistical treatment after the show significant difference (P> 0.05).Conclusion Proximal gastrectomy and anastomotic inflammation after distal gastrectomyand anastomosis of oral cavity ulcer incidence were higher, reflux esophagitis and bile reflux gastritis are a common type of long-term complications of proximal gastrectomyand distal gastrectomy.%目的 观察并对比近端胃切除和远端胃切除术后远期并发症的发生情况.方法 随机选取2013年1月~2015年1月间于本院行近端胃切除术的30例患者作为观察A组,随机选取同时期于本院行远端胃切除术的30例患者作为观察B组.结果 对比两组吻合口炎、吻合口溃疡等并发症的发生几率未见明显差异(P> 0.05);观察A组消瘦、营养不良以及反流性食管炎等并发症的发生几率明显高于观察B组,观察B组胆汁反流性胃炎的发生几率明显高于观察A组,两组数据经统计学处理后显示差异显著(P> 0.05).结论 近端胃切除术以及远端胃切除术后的吻合口炎以及吻合口腔溃疡的发生几率均较高,反流性食管炎以及胆汁反流性胃炎分

  12. Radiographic study of patients submitted to total gastrectomy using Safatle reconstruction technique Estudo radiológico em doentes submetidos a gastrectomia total com reconstrução à Safatle

    Directory of Open Access Journals (Sweden)

    Alberto Luiz Monteiro Meyer

    2008-09-01

    Full Text Available BACKGROUND: Ever since the first total gastrectomy, there has always been a great concern in increasing the survival of patients, and with the advance of techniques, in improving the quality of life of these patients. The most common reconstruction technique of the gastrointestinal transit is the Roux-en-Y. The reposition of a functional pouch in place of the resected stomach was proposed to minimize the postprandial symptoms, improve the nutritional grade and consequently, the quality of life. The Safatle reconstruction of the gastrointestinal transit technique consists of, in short, in the association of the interposition of the jejunal loop with partial transit through the duodenum, with an inverted Roux-en-Y and with the creation of a pouch which resembles the dynamics of the stomach, achieved by duodenojejunal segment which has an antiperistalsis emptying. AIM: To assess, by radiographic means, the emptying of the duodenojejunal pouch in patients submitted to total gastrectomy using the Safatle reconstruction technique. METHOD: Twelve patients submitted to total gastrectomy using the Safatle technique due to gastric cancer were studied. They were summoned to perform contrasted radiographies of the esophagus-duodenum-jejunum by the videofluoroscopic method during the months of July and August, 2005. RESULTS: All the patients presented satisfactory movement of the duodenojejunal pouch and an adequate emptying in antiperistalsis without food stasis. There has been an average 25-minute drainage time of the duodenojejunal pouch. CONCLUSION: The duodenojejunal pouch, in the patients submitted to total gastrectomy using the Safatle reconstruction, presented adequate emptying and movement.RACIONAL: Desde a primeira gastrectomia total, houve sempre a preocupação em aumentar a sobrevida e, com o aprimoramento das técnicas, de melhorar a qualidade de vida. A técnica mais aceita para a reconstrução do trânsito intestinal após gastrectomia total

  13. Clinical analysis of subtotal gastrectomy in treatment of 40 cases of acute peptic ulcer perforation%胃大部切除术治疗消化性溃疡急性穿孔40例临床分析

    Institute of Scientific and Technical Information of China (English)

    金德华

    2013-01-01

    Objective To investigate the clinical efficacy and safety of subtotal gastrectomy in the treatment of acute gastric ulcer perforation. Methods Eighty patients with acute gastric ulcer perforation admitted to our hospital from February 2009 to April 2011 were analyzed retrospectively.The observation group, consisting of 40 patients,received subtotal gastrectomy;The control group,consisting of 40 patients, received simple neoplasty.The postoperative ulcer recurrence rate,complications,hospital stay,operative time and other indicators of the two groups were compared. Results The observation group had 4 patients with grade Ⅲ Visick and 3 patients with grade Ⅳ Visick,and the control group had 6 patients with grade Ⅲ Visick and 7 patients with grade Ⅳ Visick,with statistically significant difference between the two groups (P0.05).The observation group and the control group had statistically significant differences in the operative time and hospital stay [(2.3±0.5) and (1.2±0.3) hours,(7.3±2.4) and (5.1±1.7) days,t=34.617,30.019,P=0.032,0.041]. Conclusion Subtotal gastrectomy has better long-term efficacy than simple gastric perforation repair.Under permitting conditions and with informed consent of patients, subtotal gastrectomy should be adopted as far as possible for patients with acute gastric perforation.%目的探讨胃大部分切除术急性胃溃疡穿孔的临床疗效及安全性。方法回顾性分析我院2009年2月~2011年4月收治的急性胃溃疡胃穿孔患者40例作为观察组,采用选胃大部切除术;选取同期行单纯修补术治疗急性胃溃疡胃穿孔患者40例作为对照组,比较两组术后溃疡复发率、并发症、住院天数及手术时间等各指标情况。结果观察组患者VisickⅢ级4例,VisickⅣ3例,对照组患者VisickⅢ级6例,VisickⅣ7例,二者差异有统计学意义(P<0.05);两组患者术后并发症发生率(5%和7.5%)比较,差异无统计学意义(P>0.05

  14. Successful laparoscopic distal gastrectomy with D2 lymph node dissection preserving the common hepatic artery branched from the left gastric artery for advanced gastric cancer with an Adachi type VI (group 26) vascular anomaly.

    Science.gov (United States)

    Goto, Hironobu; Yasuda, Takashi; Oshikiri, Taro; Imanishi, Tatsuya; Yamashita, Hironori; Oyama, Masato; Kakinoki, Keitaro; Ohara, Tadayuki; Sendo, Hiroyoshi; Fujino, Yasuhiro; Tominaga, Masahiro; Kakeji, Yoshihiro

    2016-12-01

    We report a case of successful laparoscopic distal gastrectomy with D2 lymph node dissection preserving the common hepatic artery branched from the left gastric artery for advanced gastric cancer with an Adachi type VI (group 26) vascular anomaly. A 76-year-old female patient was admitted with a diagnosis of advanced gastric cancer at the anterior wall to the lesser curvature of the antrum (cT3N0M0 cStage IIA). Dynamic computed tomography showed the ectopia of the common hepatic artery branched from the left gastric artery. We made a diagnosis of an Adachi type VI (group 26) vascular anomaly and performed the abovementioned operation. In this anomaly pattern, scrupulous attention is required to remove the suprapancreatic lymph nodes because the portal vein is located immediately dorsal to those lymph nodes and is at increased risk for the injury in this situation. The common hepatic artery is branched from the left gastric artery, and the hepatic perfusion from the superior mesenteric artery is not present in group 26. Planning to preserve the artery will improve safety when it is possible oncologically. There were no postoperative complications, and the patient was discharged 9 days after the operation. To our knowledge, the present case is the first reported case of a laparoscopic distal gastrectomy with D2 lymph node dissection with an Adachi type VI (group 26) vascular anomaly. Preoperative diagnostic imaging is very important to prevent surgical complications because the reliable identification of vascular anomaly during an operation is very difficult. PMID:27259578

  15. Iliotibial band syndrome: evaluation and management.

    Science.gov (United States)

    Strauss, Eric J; Kim, Suezie; Calcei, Jacob G; Park, Daniel

    2011-12-01

    Iliotibial band syndrome is a common overuse injury typically seen in runners, cyclists, and military recruits. Affected patients report lateral knee pain associated with repetitive motion activities. The diagnosis is usually made based on a characteristic history and physical examination, with imaging studies reserved for cases of recalcitrant disease to rule out other pathologic entities. Several etiologies have been proposed for iliotibial band syndrome, including friction of the iliotibial band against the lateral femoral epicondyle, compression of the fat and connective tissue deep to the iliotibial band, and chronic inflammation of the iliotibial band bursa. The mainstay of treatment is nonsurgical; however, in persistent or chronic cases, surgical management is indicated.

  16. Dust bands in the asteroid belt

    Science.gov (United States)

    Sykes, Mark V.; Greenberg, Richard; Dermott, Stanley F.; Nicholson, Philip D.; Burns, Joseph A.

    1989-01-01

    This paper describes the original IRAS observations leading to the discovery of the three dust bands in the asteroid belt and the analysis of data. Special attention is given to an analytical model of the dust band torus and to theories concerning the origin of the dust bands, with special attention given to the collisional equilibrium (asteroid family), the nonequilibrium (random collision), and the comet hypotheses of dust-band origin. It is noted that neither the equilibrium nor nonequilibrium models, as currently formulated, present a complete picture of the IRAS dust-band observations.

  17. A Novel Ku-Band/Ka-Band and Ka-Band/E-Band Multimode Waveguide Couplers for Power Measurement of Traveling-Wave Tube Amplifier Harmonic Frequencies

    Science.gov (United States)

    Wintucky, Edwin G.; Simons, Rainee N.

    2015-01-01

    This paper presents the design, fabrication and test results for a novel waveguide multimode directional coupler (MDC). The coupler, fabricated from two dissimilar frequency band waveguides, is capable of isolating power at the second harmonic frequency from the fundamental power at the output port of a traveling-wave tube (TWT) amplifier. Test results from proof-of-concept demonstrations are presented for a Ku-band/Ka-band MDC and a Ka-band/E-band MDC. In addition to power measurements at harmonic frequencies, a potential application of the MDC is in the design of a satellite borne beacon source for atmospheric propagation studies at millimeter-wave (mm-wave) frequencies (Ka-band and E-band).

  18. 3种包皮环切术的临床疗效分析%Shang Ring, sleeve and conventional circumcisions for redundant prepuce and phimosis:A comparative study of 918 cases

    Institute of Scientific and Technical Information of China (English)

    王荣; 陈伟军; 史文华; 薛一峰

    2013-01-01

    Objective: To compare the clinical effects of conventional, sleeve and Shang Ring circumcisions in the treatment of redundant prepuce and phimosis. Methods: We reviewed the clinical data of 918 patients with redundant prepuce or phimosis, 279 treated by conventional circumcision, 354 by sleeve circumcision and 285 by Shang Ring circumcision. We documented the preopera-tive characteristics, intra-operative blood loss, operation time, 4-hour and 7-day postoperative visual analogue scores, surgeons'satisfaction , incision healing time, degrees of preputial edema, postoperative complications, patients' satisfaction with penile appearance and peri-operative cost, and compared them among the three groups. Results: Shang Ring circumcision significantly reduced the operation time and intra-operative blood loss as compared with conventional and sleeve circumcisions (P <0. 05). The postoperative incision healing time was (18.6 ±5.2) d in the conventional circumcision group, (11.4 ±3.7) din the sleeve circumcision group and (20.3±5.7) d in the Shang Ring circumcision group, significantly shorter in the sleeve group than in the other two ( P < 0.05). As for the surgeons'satisfaction, postoperative complications, degree of preputial edema and patients'satisfaction with penile appearance, sleeve circumcision showed similar effects to Shang Ring circumcision but significantly better than conventional circumcision ( P < 0.05). The 7-day postoperative visual analogue score and peri-operative cost were significantly lower in the conventional and sleeve cir-cumcision groups than in the Shang Ring group (P < 0.05). Conclusion: Each of the three circumcision methods has its own advantages and disadvantages. The treatment decision should be individualized and based on a comprehensive consideration of the patients' age and economic status as well as surgeons'advice and surgical skills.%目的:比较传统包皮环切术、袖套状包皮切除术和包皮环切吻合术治疗

  19. Photonic band gap structure simulator

    Science.gov (United States)

    Chen, Chiping; Shapiro, Michael A.; Smirnova, Evgenya I.; Temkin, Richard J.; Sirigiri, Jagadishwar R.

    2006-10-03

    A system and method for designing photonic band gap structures. The system and method provide a user with the capability to produce a model of a two-dimensional array of conductors corresponding to a unit cell. The model involves a linear equation. Boundary conditions representative of conditions at the boundary of the unit cell are applied to a solution of the Helmholtz equation defined for the unit cell. The linear equation can be approximated by a Hermitian matrix. An eigenvalue of the Helmholtz equation is calculated. One computation approach involves calculating finite differences. The model can include a symmetry element, such as a center of inversion, a rotation axis, and a mirror plane. A graphical user interface is provided for the user's convenience. A display is provided to display to a user the calculated eigenvalue, corresponding to a photonic energy level in the Brilloin zone of the unit cell.

  20. Variants of lumbosacral elastic band.

    Directory of Open Access Journals (Sweden)

    Carlos Cesar Santín Alfaro

    2011-06-01

    Full Text Available It is made an intervention research, qualitative and quantitative of two variants of lumbosacral elastic bands used in Provincial Laboratory of Technical Orthopedics in Sancti Spiritus Province, taking into account the high demand for this device and that the laboratory do not often count with the raw material needed for the original lumbosacral belt made by denim cloth which is the conventional belt. The main goal of this research is to explain the technological process and to compare the cost of production of both elastic variants with lumbosacral belt made by cloth which are offer to patients who look for this service , giving them a rapid solution so that they can feel comfortable.

  1. S-band transponder experiment

    Science.gov (United States)

    Sjogren, W. L.; Gottlieb, P.; Muller, P. M.; Wollenhaupt, W. R.

    1972-01-01

    The experiment which derives data from three lunar-orbiting objects, the command-service module (CSM), the lunar module (LM), and the subsatellite in the S-band is described. Each provides detailed information on the near-side lunar gravitational field. The primary emphasis is on the low-altitude (20 km) CSM data. The LM data cover a very short time span and are somewhat redundant with the CSM data. The resolution of the high-altitude (100 km) CSM data is not as great as that of the low altitude data. The low-altitude CSM and LM data coverage and the complementary coverage obtained during the Apollo 14 mission are presented. The experiment uses the same technique of gravity determination employed on the Lunar Orbiter, in the data of which the large anomalies called mascons were first observed. The data consist of variations in the spacecraft speed as measured by the Earth-based radio tracking system.

  2. Giemsa C-banding of Barley Chromosomes. I: Banding Pattern Polymorphism

    DEFF Research Database (Denmark)

    Linde-Laursen, Ib

    1978-01-01

    Twenty barley (Hordeum vulgare) lines studied had a common basic chromosome banding pattern. Most bands ranged from medium to very small in size. The most conspicuous banding occurred at or near the centromeres, in the proximal, intercalary parts of most chromosome arms and beside the secondary c...... 7. Seventeen differently banded karyotypes were found. Some banding pattern polymorphisms can be used in cytological and cytogenetic studies....

  3. Pressure Bearing and Contact Analysis of Ball Injection Sliding Sleeve in Horizontal Well Staged Fracturing%水平井分段压裂投球滑套承压接触分析

    Institute of Scientific and Technical Information of China (English)

    徐玉龙; 程智远; 刘志斌; 李世恒; 韩永亮; 周后俊

    2012-01-01

    Due to the fact that there is no jection sliding sleeve for horizontal well staged mature matching tool for open hole completion in China, the ball infracturing suitable for Sulige Gasfield was developed. In light of the problem that the sleeve is not noticeably in place in fracturing operation, the finite element analysis software was adopted to establish the contact model of the sleeve and analyze the effect of different pressures on low-density ball, ball seat deformation and stress distribution. The analysis shows that when the operation pressure changes from 10 MPa to 20 MPa, the contact pressure is approximate to a linear change. When the pressure increases from 20 MPa to 50 MPa, the plastic deformation occurs between ball and ball seat, the contact area increases and the contact pressure increase slows down. When the pressure is 50 MPa, the maximum stress value of the ball seat reaches 358 MPa, exceeding the yield strength of low-density ball and ball seat to cause plastic deformation. But it does not reach the yield limit, satisfying the field operation requirement.%鉴于国内还没有成熟的裸眼完井配套工具,研制了适合苏里格气田的水平井分段压裂投球滑套,并针对投球滑套在压裂施工中到位不明显的问题,利用有限元分析软件ANSYS建立了投球滑套的接触模型,分析了不同压力对低密度球和球座变形与应力分布的影响。分析结果表明,施工压力由10 MPa增至20 MPa时,接触压力近似线性变化,当压力从20 MPa增加到50 MPa时,球和球座之间开始产生塑性变形,接触面积增加,从而使接触压力增加变慢。当压力为50 MPa时,球座最大应力值达到358 MPa,超过了低密度球和球座的屈服强度而发生了塑性变形,但是没有达到材料的屈服极限,满足压裂施工的要求。

  4. Sleeve Valve Pipe Miscellaneous Fill in the Foundation Seepage Control and Reinforcement%袖阀管注浆法在杂填土地基防渗加固中的应用

    Institute of Scientific and Technical Information of China (English)

    张家柱

    2013-01-01

    袖阀管注浆法通过特殊的工艺分段、分次、间歇、定量地将水泥浆液注入杂填土地层的孔隙和松散层中,被加固土体通过水泥浆液的相互作用形成了上下连续且相对密实稳定的固结体,从而使得被加固土体的密实度增大、压缩性降低、抗渗性能提高,增强了地基土的整体性和防渗能力。介绍了袖阀管注浆加固作用机理、袖阀管注浆法施工过程及质量控制要点,该方法在某防洪墙工程基础底面以下杂填土地基防渗问题处理中的应用情况:工程施工完成后经两次洪水考验,防洪墙后未发生渗水、管涌和其他险情,加固效果显著;该方法加固处理后的杂填土地层的防渗效果显著,满足设计要求。%Sleeve valve pipe grouting section,through special process and intermittent,quantitatively injects the cement grout into mixed backfill layer porosity and loose layer,reinforced soil cement slurry through the interaction and the formation of consolidation body becomes continuous and relatively dense and stable,so that by soil compaction degree increase,compressibility is reduced,anti permeability increased,enhanced soil in-tegrity and anti-seepage capacity. The sleeve valve pipe grouting reinforcement mechanism,the sleeve valve pipe grouting construction process and control,This method in a flood the wall project of foundation bottom fill application processing problems of land based in the anti-seepage reinforce-ment show that:After the two flood,flood control wall without water seepage,piping and other dangerous situation,strengthening effect;the meth-od of reinforcement of miscellaneous fill soil anti-seepage effect is remarkable,and can meet the design requirements.

  5. 阴茎中部无针麻醉袖套式包皮环切治疗包皮过长%Mid-Penis Sleeve Circumcision with Needle-Free Jet Anaesthesia for the treatment of patients with redundant prepuce

    Institute of Scientific and Technical Information of China (English)

    张伟; 申岩; 杨文增; 穆银静; 崔振宇

    2011-01-01

    Objectives To investigate mid-penis sleeve circumcision with needle-free jet anaesthesia for the treatment of patients with redundant prepuce and observe the therapeutic effect.Methods Methods outpatient circumcision 80 cases with DPNB(dorsal of penis nerve blocked)anaesthesia were randomly divided into two groups,group A(40 cases)was underwent mid-penis sleeve circumcision with needle-free jet anaesthesia,group B(40cases)was done dorsal slit circumcision with traditional DPNB,to study the difference in Anaesthetic Volume,the time of take effect,visual analogue scale(VAS),bleeding voluroue,the condition of foreskin hydropsia,operative incision healing.appearance satisfication percentage.Results Group A has statistical difference to Group B in all ahove mentioned index.Conclusions Mid-penis sleeve circumcision with needle-free jet anaesthesia has many advantages over the dorsal slit circumcision with traditional DPNB,deserving generally clinical application.%目的 探讨阴攀中部无针麻醉袖套式包皮环切治疗包皮过长的效果.方法 选择包皮过长患者105例,随机分成A,B两组,A组40例,行阴茎中部无针麻醉袖套式包皮环切术,8组40例行传统阻滞麻醉及背侧切开环切术.对两组在麻醉剂量、起效时间、视觉模拟麻醉疼痛评分、出血量、水肿、切口愈合、外观满意度等方面进行比较.结果两组所有对比项目在两组之间的差异均有统计学意义.结论 阴茎中部无针麻醉袖套式包皮切除治疗包皮过长比传统阻滞麻醉及背侧切开环切术更具有优越性,值得临床推广.

  6. Analyzing Thick-Section Composites Lug with Hole Containing Boundary Sleeve%含孔边套筒的厚截面复合材料接头耳片强度分析

    Institute of Scientific and Technical Information of China (English)

    冯蕴雯; 曹勇; 魏宇宏; 薛小锋

    2015-01-01

    A finite element( FE) modeling method with cohesive interface and sublaminates was proposed to study interlaminar stress distribution and strength of thick-section composite materials lug.And numerical calculation was carried out on the thick composite laminates three-point bending problem; effectiveness of modeling method for thick-section composite materials stress calculation was verified, Based on this, a three dimensional(3D) FE model of thick-section composite materials lug is designed;then the 3D stress distribution along the hole edge and failure mode of the lug subjected to axial load are discussed.The results and their analysis show preliminarily that:( 1) the failure stress and damage position are mainly concentrated in the no contact region of the hole-axis; stiffer metal sleeves reduce the interlaminar stress concentrations of hole edge, however, this and higher radial tensile stresses in the region lead to reduced carrying capacity of the sleeves adhesive; ( 2 ) the adhesive of sleeves fails before the thick-section composites lug; this destroyed the integrity of the protective structure and will adversely affect the strength of the thick-section composites lug.%为研究含孔边防护套筒的厚截面复合材料层合板耳片连接件孔边层间应力分布规律及接头强度,提出了采用层合板子层和界面胶层相结合的有限元建模方法,在验证了建模方法对厚截面层合板应力求解的有效性的基础上,分析了承受轴向载荷的厚层合板耳片连接件孔边三维应力分布及接头失效情况。结果表明:套筒胶层的破坏应力和破坏位置主要集中在孔轴非接触区;当套筒胶层发生断裂时,厚截面层合板并未发生失效,限制了厚板接头耳片整体强度性能的提高。

  7. The expanded perlite insulation of the riser sleeve in cement machinery in steel cast production%珍珠岩保温冒口套在铸钢件生产上的应用

    Institute of Scientific and Technical Information of China (English)

    何素立

    2012-01-01

    The compositions of expanded perlite insulation of riser sleeves include perlite, water glass and clay composites. This paper analyzes the heat preservation during production. The initial test shows that the thermal insulation of casting quality is normal and it saves 30%50% of steel, with the yield in- creased by 14%.%膨胀珍珠岩复合型保温冒口套的保温材料由膨胀珍珠岩、水玻璃及陶土组成.分析了其保温机理及制作工艺.初步生产试验表明,使用这种保温材料铸件质量正常,单个冒口节约钢水30%~50%,工艺出品率平均提高14%左右.

  8. Fade Mitigation Techniques at Ka-Band

    Science.gov (United States)

    Dissanayake, Asoka (Editor)

    1996-01-01

    Rain fading is the dominant propagation impairment affecting Ka-band satellite links and rain fade mitigation is a key element in the design of Ka-band satellite networks. Some of the common fade mitigation techniques include: power control, diversity, adaptive coding, and resource sharing. The Advanced Communications Technology Satellite (ACTS) provides an excellent opportunity to develop and test Ka-band rain impairment amelioration techniques. Up-link power control and diversity are discussed in this paper.

  9. Multi-band Modelling of Appearance

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Larsen, Rasmus

    2002-01-01

    the appearance of both derived feature bands and an intensity band. As a special case of feature-band augmented appearance modelling we propose a dedicated representation with applications to face segmentation. The representation addresses a major problem within face recognition by lowering the sensitivity...... to lighting conditions. Results show that localisation accuracy of facial features is considerably increased using this appearance representation under normal and abnormal lighting and at multiple scales....

  10. Multi-band Modelling of Appearance

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Larsen, Rasmus

    2003-01-01

    the appearance of both derived feature bands and an intensity band. As a special case of feature-band augmented appearance modelling we propose a dedicated representation with applications to face segmentation. The representation addresses a major problem within face recognition by lowering the sensitivity...... to lighting conditions. Results show that the localisation accuracy of facial features is considerably increased using this appearance representation under diffuse and directional lighting and at multiple scales....

  11. Metal band drives in spacecraft mechanisms

    Science.gov (United States)

    Maus, Daryl

    1993-05-01

    Transmitting and changing the characteristics of force and stroke is a requirement in nearly all mechanisms. Examples include changing linear to rotary motion, providing a 90 deg change in direction, and amplifying stroke or force. Requirements for size, weight, efficiency and reliability create unique problems in spacecraft mechanisms. Flexible metal band and cam drive systems provide powerful solutions to these problems. Band drives, rack and pinion gears, and bell cranks are compared for effectiveness. Band drive issues are discussed including materials, bend radius, fabrication, attachment and reliability. Numerous mechanisms are shown which illustrate practical applications of band drives.

  12. Triaxial superdeformed bands in {sup 86}Zr

    Energy Technology Data Exchange (ETDEWEB)

    Sarantites, D.G.; LaFosse, D.R.; Devlin, M.; Lerma, F. [Chemistry Department, Washington University, St. Louis, Missouri 63130 (United States); Wood, V.Q.; Saladin, J.X.; Winchell, D.F. [Physics Department, University of Pittsburgh, Pittsburgh, Pennsylvania 15260 (United States); Baktash, C.; Yu, C. [Physics Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831 (United States); Fallon, P.; Lee, I.Y.; Macchiavelli, A.O.; MacLeod, R.W. [Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720 (United States); Afanasjev, A.V.; Ragnarsson, I. [Department of Mathematical Physics, Lund Institute of Technology, Box 118, S-22100 Lund (Sweden)

    1998-01-01

    Four new superdeformed bands have been found in the nucleus {sup 86}Zr. The good agreement between experiment and configuration-dependent shell correction calculations suggests that three of the bands have triaxial superdeformed shapes. Such unique features in mass A{approximately}80 superdeformed bands have been predicted, but not observed experimentally until now. A fourth band in {sup 86}Zr is interesting due to a fairly constant and unusually high dynamic moment of inertia. Possible interpretations of this structure are discussed. {copyright} {ital 1998} {ital The American Physical Society}

  13. Magnetic resonance imaging of iliotibial band syndrome.

    Science.gov (United States)

    Ekman, E F; Pope, T; Martin, D F; Curl, W W

    1994-01-01

    Seven cases of iliotibial band syndrome and the pathoanatomic findings of each, as demonstrated by magnetic resonance imaging, are presented. These findings were compared with magnetic resonance imaging scans of 10 age- and sex-matched control knees without evidence of lateral knee pain. Magnetic resonance imaging signal consistent with fluid was seen deep to the iliotibial band in the region of the lateral femoral epicondyle in five of the seven cases. Additionally, when compared with the control group, patients with iliotibial band syndrome demonstrated a significantly thicker iliotibial band over the lateral femoral epicondyle (P iliotibial band in the disease group was 5.49 +/- 2.12 mm, as opposed to 2.52 +/- 1.56 mm in the control group. Cadaveric dissections were performed on 10 normal knees to further elucidate the exact nature of the area under the iliotibial band. A potential space, i.e., a bursa, was found between the iliotibial band and the knee capsule. This series suggests that magnetic resonance imaging demonstrates objective evidence of iliotibial band syndrome and can be helpful when a definitive diagnosis is essential. Furthermore, correlated with anatomic dissection, magnetic resonance imaging identifies this as a problem within a bursa beneath the iliotibial band and not a problem within the knee joint.

  14. Density of States for Warped Energy Bands

    Science.gov (United States)

    Mecholsky, Nicholas A.; Resca, Lorenzo; Pegg, Ian L.; Fornari, Marco

    2016-02-01

    Warping of energy bands can affect the density of states (DOS) in ways that can be large or subtle. Despite their potential for significant practical impacts on materials properties, these effects have not been rigorously demonstrated previously. Here we rectify this using an angular effective mass formalism that we have developed. To clarify the often confusing terminology in this field, “band warping” is precisely defined as pertaining to any multivariate energy function E(k) that does not admit a second-order differential at an isolated critical point in k-space, which we clearly distinguish from band non-parabolicity. We further describe band “corrugation” as a qualitative form of band warping that increasingly deviates from being twice differentiable at an isolated critical point. These features affect the density-of-states and other parameters ascribed to band warping in various ways. We demonstrate these effects, providing explicit calculations of DOS and their effective masses for warped energy dispersions originally derived by Kittel and others. Other physical and mathematical examples are provided to demonstrate fundamental distinctions that must be drawn between DOS contributions that originate from band warping and contributions that derive from band non-parabolicity. For some non-degenerate bands in thermoelectric materials, this may have profound consequences of practical interest.

  15. Flat-band engineering of mobility edges

    Science.gov (United States)

    Danieli, Carlo; Bodyfelt, Joshua D.; Flach, Sergej

    2015-06-01

    Properly modulated flat-band lattices have a divergent density of states at the flat-band energy. Quasiperiodic modulations are known to host a metal-insulator transition already in one space dimension. Their embedding into flat-band geometries consequently allows for a precise engineering and fine tuning of mobility edges. We obtain analytic expressions for singular mobility edges for two flat-band lattice examples. In particular, we engineer cases with arbitrarily small energy separations of mobility edge, zeroes, and divergencies.

  16. Band engineering of thermoelectric materials.

    Science.gov (United States)

    Pei, Yanzhong; Wang, Heng; Snyder, G J

    2012-12-01

    Lead chalcogenides have long been used for space-based and thermoelectric remote power generation applications, but recent discoveries have revealed a much greater potential for these materials. This renaissance of interest combined with the need for increased energy efficiency has led to active consideration of thermoelectrics for practical waste heat recovery systems-such as the conversion of car exhaust heat into electricity. The simple high symmetry NaCl-type cubic structure, leads to several properties desirable for thermoelectricity, such as high valley degeneracy for high electrical conductivity and phonon anharmonicity for low thermal conductivity. The rich capabilities for both band structure and microstructure engineering enable a variety of approaches for achieving high thermoelectric performance in lead chalcogenides. This Review focuses on manipulation of the electronic and atomic structural features which makes up the thermoelectric quality factor. While these strategies are well demonstrated in lead chalcogenides, the principles used are equally applicable to most good thermoelectric materials that could enable improvement of thermoelectric devices from niche applications into the mainstream of energy technologies.

  17. Band head spin assignment of Tl isotopes of superdeformed rotational bands

    Science.gov (United States)

    Goel, Alpana; Nair, Uma; Yadav, Archana

    2014-09-01

    The Variable Moment of Inertia (VMI) model is proposed for the assignment of band head spin of super deformed (SD) rotational bands, which in turn is helpful in the spin prediction of SD bands. The moment of inertia and stiffness parameter (C), were calculated by fitting the proposed transition energies. The calculated transition energies are highly dependent on the prescribed spins. The calculated and observed transition energies agree well when an accurate band head spin (I 0) is assigned. The results are in good agreement with other theoretical results reported in literature. In this paper, we have reported the band head spin value 16 rotational band of super deformed Tl isotopes.

  18. Comparative Study of Laparotomy and Laparoscopic-assisted Radical Distal Gastrectomy%开腹及腹腔镜辅助根治性远端胃切除的对比研究

    Institute of Scientific and Technical Information of China (English)

    高金辉; 李建国; 蔡铭智; 蔡丽生; 曾燕华

    2014-01-01

    Objective-To-explore-the-feasibility-of-laparoscopic-assisted-radical-distal-gastrectomy-.-Methods-We-retrospectively-reviewed-the-clinical-data-of-16-cases-undergoing-laparoscopic-gastrectomy-(-laparoscopic-group-)-and-16-cases-undergoing-open-gastrectomy-(-open-group-)-in-our-hospital-from-March-2011-to-June-2012.The-operation-time-,-intraoperative-blood-loss,-number-of-lymph-node-dissected-,-postoperative-anal-exhaust-time-,-time-to-liquid-diet,-and-complications-were-compared-between-the-two-groups.-Results-Compared-with-the-open-group,-the-operation-time-of-laparoscopic-gastrectomy-was-longer-[(183.4-±-20.2)-min-vs.(143.4-±21.6)-min,-t-=5.400,-P-=0.000],-but-the-hemorrhage-volume-was-less-[(157.5-±30.1)-ml-vs.-(183.1-±28.4)-ml,-t=-2.474,-P=0.010],-the-anal-exhaust-time-after-operation-was-earlier-[(2.8-±0.3)-d-vs.(3.6-±0.3)-d,-t=-7.005,-P=0.000],-and-time-to-liquid-diet-after-operation-was-earlier-[(2.9-±0.2)-d-vs.(4.0-±0.2)-d,-t=-13.421,-P=0.000].There-were-no-differences-in-number-of-lymph-nodes-removed-and-complications-between-the-two-groups-(P>0.05).In-the-laparoscopic-group-,-there-were-3-cases-of-pulmonary-infection-,-1-case-of-gastric-paralysis-,-and-1-case-of-anastomotic-bleeding-.In-the-open-group,-there-were-2-cases-of-pulmonary-infection,-2-cases-of-gastric-paralysis,-and-3-cases-of-incisional-infection-or-fat-liquefaction-.-Conclusions-Laparoscopic-gastrectomy-is-feasible-and-safe-for-patients-with-gastric-cancer-.It-can-be-performed-safely-with-comparable-early-curative-effects-to-open-gastrectomy-,-bearing-advantages-of-clear-vision-,-small-trauma-,-less-bleeding-,-and-fast-recovery.%目的:探讨腹腔镜辅助根治性远端胃切除术的可行性。方法回顾性分析我院2011年3月~2012年6月行腹腔镜辅助及开腹根治性远端胃切除术各16例的临床资料。比较2组手术时间、出血量、清扫淋巴结数、术后肛门排气时间、开始流质饮食时间及并发症。结果与开腹组相比,虽

  19. 胃癌D2根治术后迟发性出血的临床分析及防治%Analysis and prevention of postoperative delayed hemorrhage associated with radical D2 gastrectomy

    Institute of Scientific and Technical Information of China (English)

    王君辅; 谢勇; 胡林; 李昌荣; 李伟峰; 李红浪

    2016-01-01

    目的:探讨胃癌D2根治术后迟发性出血的原因、处理方法及预后防治。方法:回顾性分析南昌大学第二附属医院2015年1月至2015年10月294例胃癌D2根治患者的临床资料。结果:15例患者手术后发生迟发性大出血,占同期患者的5.1%(15/294),其中腹腔镜下胃癌根治术9例、开腹胃癌根治术6例;大血管出血7例,吻合口漏、吻合口溃疡致出血3例,十二指肠残端破裂致出血2例,其他部位出血2例,部位不明1例。11例经二次手术,2例经数字减影血管造影(digital subtraction angiography,DSA)+经导管介入下动脉栓塞(transcathete arterial embolization,TAE)止血,1例经内镜下止血,1例经保守治疗,二次手术率73.3%(11/15),死亡率40%(6/15),治愈率60%(9/15)。结论:胃癌D2根治术后迟发性出血二次手术率及死亡率较高,临床中需综合患者出血情况及原因积极采取治疗。重大血管出血、吻合口漏、吻合口溃疡、十二指肠残端破裂是最重要危险因素,腹腔动脉性出血及吻合口漏并发症引起出血是最主要致死原因。对于出血量大,生命体征不稳定患者应及时行二次手术和腹腔引流术为有效的处理方法;对于生命体征平稳,出血量少患者可行保守治疗;对于单纯吻合口溃疡出血患者可采取内镜下止血;对于出血部位不明患者可行DSA明确出血部位,再行TAE治疗。%Objective:To investigate the cause, treatment, and prognosis of delayed hemorrhage in patients who underwent radical gastrectomy. Methods:The clinical data of 294 patients who underwent radical gastrectomy in the Second Hospital Affiliated from Nanchang University from January 2015 to October 2015 were retrospectively analyzed. Results:A total of 15 patients suffered from delayed hemorrhage and accounted for 5.1%of the gastric cancer cases in our hospital for the same period of radical

  20. Comparison of X-Band, L-Band and C-Band Radar Images in Monitoring Subsidence in Agricultural Regions

    Science.gov (United States)

    Motagh, Mahdi; Haghshenas Haghighi, Mahmud; Shamshiri, Roghaye; Esmaeili, Mustapha

    2015-05-01

    The ongoing pattern of groundwater induced land subsidence in major valleys and agricultural regions of Iran has been recently documented by several studies (e.g. [1-4]) using C-band Interferometric Synthetic Aperture Radar (InSAR) observations. In this article we present the results of our research in which we evaluated the performance of C-band, L-band and X-band SAR data, using time-series method of small baseline subset (SBAS), to retrieve long time series of ground subsidence in agricultural regions in the country. Two major groundwater basins have been selected for this purpose: (1) Rafsanjan Valley in the Kerman province of central Iran and (2) Tehran Plain (capital of Iran). We also report on our experience using dualpolarimetry (HH/VV) X-band SAR data for Persistent Scatterer (PS) deformation analysis in natural terrains subject to high rate of deformation.